Humeral Shaft Fracture Flashcards
Which nerve is at highest risk of damage in a humeral shaft fracture
Radial nerve due to being in the spiral groove
What are the risk factors of humeral shaft fractures
Osteoporosis
Increasing age
Previous fractures
what are the clinical features of a humeral shaft fracture
Pain and deformity
If radial nerve damage then reduced sensation over 1st dorsal webspace and weakness in wrist extension
Check neurovascular status
Assess for open wounds
What is a Holstein Lewis fracture
Fracture of the distal third of the humerus resulting in radial nerve entrapment
The resultant neuropraxia to the radial nerve will result in loss of sensation in the radial distribution and a wrist drop deformity. Surgical management is indicated in such cases.
What are the investigations needed
AP and lateral plain radiographs
In comminuted fractures - CT may be needed
What is the management of a humeral shaft fracture
Conservative treatment
What are the criteria for patient being suitable for conservative management
<20o anterior angulation, <30o varus or valgus angulation, and with <3cm of shortening
How long does it take for full union
8-12 weeks
What is the surgical management of patients with humeral shaft fractures
involve open reduction and internal fixation with a plate.
Intramedullary nailing may be indicated in the presence of pathological fractures, polytrauma, or severely osteoporotic bones.
What are the complications
Varus angulation is slightly more common with transverse fractures, however rarely causes functional limitations
Non-union and mal-union
How long will radial nerve injuries take to heal
radial nerve injuries will improve within 3 months without any intervention.
