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[Indications for the surgical and conservative treatment of juvenile supracondylar humeral fractures and their results].

In the period from 1977 to 1982 78 children were treated for supracondylar fractures of the humerus at the Berufsgenossenschaftliche Unfallklinik Frankfurt/Main. Indications and methods for operative and conservative treatment are described. The results of therapy were reviewed by means of a questionnaire or reexamination in 68 patients with regard to function, elbow deformity and nerve lesions. Fractures of a grade I severity are to be treated conservatively by immobilisation in a POP-cast. Only in exceptional cases of grade II severity can a closed reduction be recommended. All remaining typ

Revascularization of the humeral head. A report of two cases of fracture-dislocation of the shoulder.

Two cases of fracture-dislocation of the shoulder are reported in which the humeral heads were found at open reduction to be without soft tissue attachments. The patients were followed up clinically and radiologically and by technetium-99m scintigraphy for at least two years. In the case of a three-part fracture-dislocation, revascularization of the humeral head was complete three months after surgery, whereas the humeral head in the four-part fracture-dislocation did not appear totally revascularized scintigraphically until nine months after surgery. Radiologic signs of avascular necrosis of

[Effect of dia- and percondylar humeral fractures on the growth of the carpal bones in children].

Using surface measurements obtained from anterior-posterior X-rays, the carpal bones on the side of the previous supracondylar fracture were compared with those on the uninjured side. A disparity in growth was found between the two sides. Most often, an increased growth of the scaphoid was seen on the side of the fracture. Analysis of the data obtained from the measurements of all carpal bones did not lead to any definite conclusions. Of the seven carpal bones studied, a greater length (1 to 3 mm.) was found 86 times and a greater width (1 to 4 mm.) 53 times. Decreased length (1 to 4 mm.) was

Endosteal strut using a hydroxyapatite/poly-L-lactide mesh tube with a proximal humeral locking plate for the treatment of proximal humeral fractures.

PURPOSE: Proximal humeral fractures cause large intramedullary bone defects after humeral-head reduction. Hydroxyapatite/poly-L-lactide (HA/PLLA) materials are widely used for various fractures. However, the efficacy of endosteal strut using a HA/PLLA mesh tube (ES-HA/PLLA) with a locking plate for treating proximal humeral fractures was not reported. The purpose of this study is to examine the efficacy of ES-HA/PLLA with a proximal humeral locking plate in proximal humeral fractures. METHODS: Seventeen patients with proximal humeral fractures treated using ES-HA/PLLA with a locking plate fro…

Humeral Shaft Stress Fracture Completion in a Weight Lifter: A Case Report.

CASE: A 34-year-old man, amateur weight lifter presented with acute worsening of right shoulder pain after 5 months of prodromal, progressive, atraumatic pain. Imaging showed a short oblique proximal third humeral shaft fracture without evidence of other osseous abnormalities. He was treated operatively with open reduction and internal fixation, healed uneventfully, and returned to weight lifting within 3 months. CONCLUSION: Humeral shaft stress fractures most commonly occur in athletes or military personnel who engage in repetitive overhead activity. It is important to include stress fractur

Effect of cerclage wiring on humeral shaft fracture associated with the third fragment.

INTRODUCTION: In humeral shaft fractures, the presence of a free bone fragment, called the third fragment or butterfly fragment, is thought to induce non-union. We hypothesised that non-union and subsequent reoperations could be reduced by performing cerclage wiring for fragments, in addition to intramedullary nailing for fractures with the third fragment. This study aimed to examine the effectiveness of cerclage wiring for the third fragments associated with humeral shaft fractures. MATERIALS AND METHODS: This study included patients with humeral shaft fractures involving the third fragment,

A Study on Functional Outcome of Hemiarthroplasty for Proximal Humeral Fractures - An Observational Study.

INTRODUCTION: Proximal humeral fractures (PHFs) represent a significant portion of fragility fractures in the elderly, ranking third after hip and distal radius fractures. While the majority of minimally displaced PHFs can be managed nonoperatively, displaced three- and four-part fractures often require surgical intervention. Hemiarthroplasty (HA) has traditionally been used for complex fracture patterns. With recent advances in prosthetic design and surgical techniques, HA continues to be a valuable option. CASE SERIES: This case series evaluated patients with Proximal humeral fractures, Thi…

Risk Factors and Impact on Survival of Pathological Fractures in Patients With Humeral Metastasis.

Background Bone metastases often cause pathological fractures and impair patients' quality of life and survival. Although several studies have been conducted on pathological fractures in the femur and spine, limited research has been done on the upper limbs. This study aimed to reveal the risk factors and determine how pathological fractures impact survival in patients with humeral metastasis. Methods This retrospective study was based on patients with humerus metastasis treated in the Nagoya-City University Hospital from 2010 to 2020. Patient characteristics, including sex, age at diagnosis o

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… Previous reports have also shown that surgery for pathological humeral fractures is effective in terms of pain relief and functional recovery [ 21 , 22 ], which is consistent with our results. … Conclusions Our study suggested that bone-modifying agents have the benefit of preventing pathological fractures due to humeral metastases, and larger circumferential cortical involvement was a predictive factor for pathological humeral fractures. …

Anterior Shoulder Dislocation With an Ipsilateral Humeral Shaft Fracture: A Case Report.

Anterior shoulder dislocation is the most common type of shoulder dislocation but if accompanied by an ipsilateral humeral shaft fracture, it becomes extremely rare. There was no clear approach for dealing with these cases. We would like to present a case of a 17-year-old medically free male who was brought to the emergency department by ambulance after a road traffic accident. The patient was conscious, alert, and oriented. His Glasgow Coma Scale (GCS) was 15/15. He had multiple bruises all over his body with obvious swelling in his right arm with an inability to move the arm. There was tende

Challenges in the Management of Supracondylar Humeral Fractures in Children in Resource-Constrained Settings.

Upper limb fractures are quite common in children accounting for about 90% of all paediatric fractures. They are more common in males than in females. The supracondylar humeral fracture variety is one of the most common, requiring operative intervention. It is known to be associated with complications such as neurovascular injuries as well as elbow stiffness and cubitus varus. The management of the fracture in the absence of basic suitable imaging facilities poses great challenges to the orthopaedic surgeon.

[Clinical application of dynamic locking screw in treating humeral shaft fracture].

OBJECTIVE: To compare clinical effect of dynamic locking screws and common screws in treating humeral shaft fractures. METHODS: From January 2016 to October 2018, clinical data of 46 patients with humeral shaft fracture were retrospectively analyzed, which were divided into dynamic locking screw internal fixation group (treatment group) and ordinary screw internal fixation group (control group). In treatment group, there were 14 males and 10 females, aged from 20 to 61 years old with an average of (36.8±10.9) years old;22 patients in control group, there were 13 males and 9 females, aged from

Trochlear Osteonecrosis After a Nonoperative Lateral Humeral Condyle Fracture in a Child.

This patient originally presented at the age of 2 years with a 1-mm displaced lateral humeral condyle fracture after a fall. He was treated nonoperatively in a long-arm cast, and serial x-rays were followed for 1 month. At the 1-month clinic visit, the lateral condyle demonstrated excellent alignment and healing, and the long-arm cast was removed. He eased back into activities and was doing well at 3 months. He returned over 4 years later, at the age of 7 years, with the report of elbow clicking with motion. At that time, imaging demonstrated collapse of the ulnohumeral articulation.

Evaluation of Fixation for Distal Humeral Diaphyseal Fracture by Locking Compression Plate.

Treatment of extra-articular distal humeral shaft fractures with plating techniques is often difficult. The recent development of LCP has improved the surgical treatment of fractures by overcoming the few drawbacks of older fixators. The aim of this prospective observational study was to assess the effectiveness of osteosynthesis of extra-articular diaphyseal fractures of the distal third of the humerus using a single locking compression plate (LCP) and was conducted from July 2016 to June 2018 at the National Institute of Traumatology and Orthopedic Rehabilitation (NITOR), Dhaka, Bangladesh.

Retrospective analysis of proximal humeral fracture-dislocations managed with locked plates.

BACKGROUND: Fracture-dislocation is the extreme variant of injury to the proximal humerus that occurs more commonly in young adults as a result of high-velocity trauma. We evaluated the functional and radiologic outcome of fixation of proximal humeral fracture-dislocations with locked plates. METHODS: This was a retrospective review of 33 proximal humeral fracture-dislocations in 29 patients with a mean age of 35 years (range, 19-60 years) treated by open reduction and internal fixation with locked plates between January 2009 and December 2013. The fracture-dislocation in 85% was the result o

Cement technique correlates with tuberosity healing in hemiarthroplasty for proximal humeral fracture.

BACKGROUND: Tuberosity healing correlates with clinical outcomes after hemiarthroplasty for 4-part proximal humeral fractures (4PHFs). We seek to examine variables that affect tuberosity healing. METHODS: This was a retrospective comparative study. At 1 year postoperatively, patients who underwent hemiarthroplasty for 4PHFs were divided into 2 groups: those with anatomically healed tuberosities and those with tuberosity nonunion. The primary variables included time between injury and surgery, prosthesis fenestration, cement mantle classification, and both vertical and horizontal tuberosity re…

Leverage application on Gartland type IV supracondylar humeral fracture in children.

PURPOSE: Although the most complex management of Gartland type IV supracondylar humeral fracture (SCHF) due to instability, the gold standard of initial treatment remains closed reduction and percutaneous pinning. However, open reduction was inevitable in most published studies. This study reports the outcome of treatment by leverage-assisted closed reduction. METHOD: Twenty-seven patients were diagnosed as Gartland type IV SCHF during surgery in 214 preoperative Gartland type III fractures. Leverage-assisted reduction with percutaneous lateral pinning was done in these patients after failure

Fracture of the Medial Humeral Epicondyle in Children: A Comparison of Operative and Nonoperative Management.

To compare clinical and radiographic outcomes of medial epicondylar fractures treated operatively to those treated nonoperatively, 30 patients with 31 fractures were divided into three groups: (a) nondisplaced, six treated nonoperatively; (b) incarcerated fragment, four with operative treatment; and (c) displaced but not incarcerated, 21 fractures, 14 treated operatively and seven nonoperatively. Clinical outcomes were assessed with follow-up examination and the Japanese Orthopaedic Association elbow assessment score. Average elbow scores were 98 in nondisplaced fractures, 94 with an incarcera

Vascular injuries in supracondylar humeral fracture: an active approach to diagnosis and treatment.

AIM: The strategy with vascular complications of supracondylar humeral fractures (SHF) is under scrutiny since modern diagnostic techniques, particularly ultrasound investigations, provide earlier and more precise assessment and updated vascular surgical procedures, particularly microvascular ones, obtain excellent results. The purpose of this study was to look prospectively at what could be achieved by early systematic diagnostic investigations and, when appropriate, immediate arterial exploration and repair. METHODS: Sixty-three pediatric patients with SHF were admitted and treated in our S…

Outcomes following distal humeral fracture fixation with an extensor mechanism-on approach.

BACKGROUND: Distal humeral fractures have traditionally been managed with surgical approaches that disrupt the extensor mechanism. We hypothesized that an extensor mechanism-on approach for operative fixation of distal humeral fractures with parallel or orthogonal plate constructs would allow excellent healing, a motion arc of the elbow exceeding 100°, and maintenance of extensor mechanism strength. METHODS: Distal humeral open reduction and internal fixation (ORIF) was performed with either orthogonal or parallel plate constructs in seventy-nine elbows. Thirty-seven elbows were fixed via an …

Upper-extremity deep venous thrombosis following humeral shaft fracture.

Upper-extremity deep venous thrombosis (DVT), although not as common as its lower-extremity counterpart, is a clinical entity with potentially devastating complications. Approximately 1% to 4% of all DVT cases involve the upper extremity, with 9% to 14% of these cases complicated by pulmonary embolism. Prompt diagnosis with duplex ultrasonography and subsequent anticoagulation are the gold standards for identification and treatment. The majority of these cases are secondary to medical comorbidities such as malignancy, hypercoagulable states, and indwelling catheters. Although rare, several cas