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[Emergency closed reduction and percutaneous Kirschner wire fixation for treatment of Gartland type II-III supracondylar fractures of the humerus in children].

OBJECTIVE: To analyze the clinical effect and related risk factors of Gartland type II-III supracondylar fractures of humerus in children in the emergency closed reduction and percutaneous Kirschner wire fixation. METHODS: From January 2008 to June 2013,112 children of Gartland type II to III supracondylar humeral fractures were treated in children in emergency closed reduction and percutaneous K-wire fixation, including 72 males and 40 females with an average age of 6.2 years old ranging from 2 to 11 years old. Among them,74 cases were in Gartland type II fractures,38 cases were in type III;…

Outcome of Double Tension Band Wiring Method for the Treatment of Intercondylar Fractures of Humerus.

Distal humeral fractures are relatively rare injuries that constitute approximately 2% of all fractures which occur due to high energy trauma in young males. Because they involve the articular surface and usually cause an instable elbow, surgical treatment is necessary for the recovery of elbow functions in the majority of cases. The principles of absolute stabilization and early mobilization in the elbow are of more importance than in any other joint. As the AO classification, nonunion and implant loosening is more common in type C fractures of the distal humerus involving the joint surface. …

Delayed Radial Nerve Injury from a Brachial Artery Pseudoaneurysm Following a Four-Part Proximal Humerus Fracture: A Case Report and Literature Review.

CASE: Following a 4-part proximal humerus fracture at the level of the surgical neck, an 84-year-old woman presented with delayed radial nerve deficits secondary to a brachial artery pseudoaneurysm. She underwent emergent repair of the vessel and reverse total shoulder arthroplasty. The deficit remained present at 1-year follow-up and is unlikely to improve. CONCLUSIONS: Brachial artery pseudoaneurysms can occur following humeral fractures. Fractures at this location can lead to the unique complication of a proximal pseudoaneurysm that compresses the radial nerve. It should be considered a po…

[EFFECTIVENESS OF LOCKING COMPRESS PLATE FOR TREATMENT OF ASEPTIC DIAPHYSEAL HUMERAL NONUNIONS].

OBJECTIVE: To evaluate the effectiveness of locking compress plate (LCP) for the treatment of aseptic diaphyseal humeral nonunions. METHODS: Between January 2006 and January 2012, 23 patients with aseptic diaphyseal humeral nonuninons were treated with LCP and autologous iliac crest bone graft, and the clinical data were retrospectively analyzed. There were 15 males and 8 females with the average age of 42.5 years (range, 28-60 years). The fracture located at left side in 11 cases and right side in 12 cases. The mechanism of the injury was traffic accident in 15 patients, and falling from hei

InSafeLOCK® humeral nailing for humeral nonunions: Clinical and radiological results.

OBJECTIVES: This study aims to evaluate the clinical and functional results of patients treated with InSafeLOCK® humeral nail and iliac crest autograft for humeral nonunion. PATIENTS AND METHODS: A total of 15 patients (11 males, 4 females; mean age: 52.1±15.3 years; range, 31 to 78 years) who were followed conservatively for humeral fractures and operated with the InSafeLOCK® humeral nail and iliac bone graft in our center between June 2018 and January 2020 were retrospectively analyzed. Data including demographic and clinical characteristics of the patients, operative data, and pre- and pos…

Short, locked humeral nailing via Neviaser portal: an anatomic study.

OBJECTIVE: Supraspinatus tendon trauma may contribute to residual shoulder pain after nail fixation for proximal humeral fractures. Some have proposed a more medial starting point for humeral nail insertion to avoid cuff tendon footprint damage. We hypothesized that percutaneous nail insertion via Neviaser portal would not only be possible, but would avoid tendon trauma, while sacrificing articular cartilage. MATERIALS AND METHODS: Under c-arm guidance and in percutaneous fashion, we nailed 16 consecutive complete (head and neck, etc, intact) specimen right proximal humeri with locked short h…

Surgical Management of Proximal Humerus Fractures in Patients With Common Injury-Specific Comorbidities.

When evaluating a humeral neck fracture for surgical intervention, it is prudent to evaluate the patient for the common injury-specific comorbidities of alcoholism and osteoporosis, as the presence of either of these conditions, require additional considerations to prevent complications. This case presents a 63-year-old female who presented for evaluation after multiple falls. She was discharged from an outside facility one week prior with a left (nondominant extremity) humeral neck fracture. Her condition was complicated by alcohol use disorder with recent heavy alcohol use. On hospital stay

[Concomitant fractures of the capitulum humeri and the caput radii].

This case report describes the osteosynthetic treatment and postoperative course of a fracture of the capitulum humeri and a concomitant fracture of the head of the radius with a follow-up over 3 months. Simultaneous fractures of the capitulum humeri and the head of the radius are rare injuries of the elbow. Due to the complex anatomical relationships this type of fracture poses a big challenge for treating traumatologists.

Septic Nonunion Caused by Mycobacterium canariasense: A Case Report.

CASE: A 43-year-old former drug user presented with a mycobacterium-caused septic nonunion of the humeral shaft. The patient had undergone 2 previous surgeries for a hematogenous fracture-related infection due to Staphylococcus aureus. The procedures had included debridement, double-plate osteosynthesis, and placement of a gentamicin-loaded bone substitute. Culture specimens produced growth of Mycobacterium canariasense. Because the microbiological diagnosis was obtained after the patient had been discharged, no antibiotic treatment could be prescribed. Nevertheless, solid bone fusion was obse

The relationship of proximal locking screws to the axillary nerve during antegrade humeral nail insertion of four commercially available implants.

OBJECTIVE: The purpose of this study was to determine the proximity of proximal interlocking mechanisms in 4 current antegrade humeral nails to the axillary nerve and its branches. DESIGN: Cadaveric study. SETTING: Anatomy laboratory. MAIN OUTCOME MEASURE: Anatomic relationships. METHODS: Four humeral nail designs (labeled SS, SL, SZ, and SN) were each inserted in successive antegrade fashion in 10 cadaveric upper extremity specimens. Three variables were measured: from acromion to the axillary nerve, from acromion to entry sites of proximal locking devices, and from locking devices to axi

Traumatic pediatric shoulder fracture dislocation treated with closed reduction and intramedullary nailing: A case report.

BACKGROUND: Although rare, pediatric proximal humerus fractures may coexist with glenohumeral dislocations. Most of these injuries are Salter -Harris type of injuries. The treatment usually consists of closed or open reduction and k- wires fixation. THE CASE: In this case report; a 10-year-old girl presented with a rare traumatic humeral surgical neck fracture with a posterior shoulder dislocation that was treated by closed reduction and flexible intramedullary nailing. CONCLUSION: Pediatric humerus fracture dislocations are rare. Treatment should keep in mind preservation of the growth plat

Comparative Evaluation of Two Fluoroscopic Techniques in Pediatric Supracondylar Humerus Fractures: A Retrospective Study on Surgical Efficiency and Early Outcomes.

BACKGROUND Supracondylar humerus fractures are the most common elbow fractures in children and are frequently treated with closed reduction and percutaneous pinning when displaced. Because this procedure relies heavily on intraoperative fluoroscopy, surgical setup can influence operative time, radiation exposure, and workflow efficiency. However, comparative evidence on different fluoroscopic positioning strategies and antisepsis protocols remains limited. This retrospective, non-randomized study was designed to compare a conventional technique with a modified fluoroscopic approach in pediatri

K-wire versus screws in the fixation of lateral condyle fracture of humerus in pediatrics: a systematic review and meta-analysis.

BACKGROUND: Lateral condyle fracture of the humerus is the second most common elbow fracture in children. Non-displaced lateral condyle fractures can often be managed with cast and conservative care, while reduction and fixation are often used to treat displaced lateral condyle fractures. Traditionally, K-wire fixation has been used for displaced lateral condyle fractures, but recently fixation using screws has been advocated in some studies. Therefore, we performed a meta-analysis to determine the difference in outcomes and complications between the two different fixation methods for the trea

Intramedullary Nailing with and without the Use of Bone Cement for Impending and Pathologic Fractures of the Humerus in Multiple Myeloma and Metastatic Disease.

Although intramedullary nailing (IMN) is considered the standard of care for the surgical management of most femur metastatic diseases, the optimal treatment of metastatic humeral impending and/or pathologic fractures is still debatable. Moreover, the use of cemented humeral nails has not been thoroughly studied, and only a few small series have compared their results with uncemented nails. The purpose of this study was to compare the (1) survivorship, (2) functional outcomes, and (3) perioperative complications in patients receiving cemented versus uncemented humerus IMN for impending or comp

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… Discussion Patients presenting with impending or complete pathologic humeral fractures, secondary to metastatic bone disease or myeloma, may be treated with multiple modalities. … fractures. …

Spiral fracture of the radius: an unusual case of shoulder dystocia-associated morbidity.

BACKGROUND: The most common neonatal complications associated with shoulder dystocia include transient brachial plexus palsy, clavicular fracture, and humeral fracture. Fracture of the fetal radius has not been previously reported. CASE: We encountered a shoulder dystocia with the fetal head in the right occiput anterior position that necessitated the McRoberts maneuver, suprapubic pressure, the Wood and Rubin maneuvers, and extraction of the posterior fetal arm to effect delivery. The 4610-g infant experienced a spiral fracture of the right (anterior) radius and a fracture of the left (poste

Surgical anatomy of the axillary nerve and its implication in the transdeltoid approaches to the shoulder.

BACKGROUND: Traumatic and iatrogenic injuries of the axillary nerve (AN) are frequent in clinical practice; nevertheless, its anatomy and its relationships with the transdeltoid approaches to the shoulder are not well documented. MATERIALS AND METHODS: Anatomic study was performed on 16 shoulders of unembalmed cadavers. A proximal humeral internal locking system (PHILOS) plate was placed to simulate the osteosynthesis of a fracture of humeral surgical neck. The relationships between the plate and the nerve were evaluated. Selective dissection of all the nerve branches inside the deltoid muscl

Reverse shoulder arthroplasty: State-of-the-art.

The reverse shoulder arthroplasty conceived by Paul Grammont in 1985 has gradually gained popularity as a treatment for multiple shoulder diseases. Unlike previous reverse shoulder prosthesis characterized by unsatisfactory results and a high glenoid implant failure rate, the Grammont design has immediately shown good clinical outcomes. This semi constrained prosthesis solved the issues of the very first designs by medializing and distalizing the center of rotation with an increased stability of the replacement of the component. The indication was initially limited to cuff tear arthropathy (CT