Humeral Shaft Fracture.pptx

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humerus fracture

$Humeral shaft fractures • Humeral shaft fractures account for approximately 1-3% of all fractures • Usually the result of blunt trauma such as a fall or from high-energy trauma including motor vehicle accidents and gunshot injuries • Fracture displacement is the result of muscular forces$

TREATMENT OPTIONS
Non-Operative
• Coaption splint
• Hanging arm cast
• Function orthosis
Operative
• Compression plating
• Intramedullary fixation
• Antegrade
• Retrograde
• Interlocking
• Flexible
• External fixation

Non-Operative
• Indication :
• Isolarted Injury
• Aadequate aligment after splinting
• AP bowing < 200
• Lateral bowing < 300
• Preferred method
• Functional orthosis

$Humeral Shaft Fracture Operative Indication • Open fracture • Vascular injury • Radial nerve palsy after closed reduction • Floating elbow • Failure of closed treatment • Pathologic fracture (bone metastases) • Brachial plexus injury$

$Relative Operative Indication • Polytrauma • Bilateral Humeral Fracture • Morbid obesity • Segmental fracture • Need to use crutches$

Humerar Shaft Fracture
Operative Option
• Plate fixation
• Interlocking IM nail
• Ender’s nails, rush rods
• External fixation

$External Fixation • Open fracture with extensive soft-tissue injuries • Severe contamination$

$Iindication For Plate Fixation • Fracture requiring nerve or vascular exploration • Very distal fracture • Very proximal fractures • Any diaphyseal fracture$

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Distal femur fractures are traumatic injuries involving the region extending from the distal metaphyseal-diaphyseal junction to the articular surface of the femoral condyles. Diagnosis is made radiographically with CT studies often required to assess for intra-articular extension. Treatment is generally operative with ORIF, intramedullary nail, or distal femur replacement depending on available bone stock, age of patient, and patient activity demands. Patella Fractures are traumatic knee injuries caused by direct trauma or rapid contracture of the quadriceps with a flexed knee that can lead to loss of the extensor mechanism. Diagnosis can be made clinically with the inability to perform a straight leg raise and confirmed with radiographs of the knee. Treatment is either immobilization or surgical fixation depending on fracture displacement and integrity of the extensor mechanism. Proximal third tibia fractures are relatively common fractures of the proximal tibial shaft that are associated with high rates of soft tissue compromise and malunion (valgus and procurvatum). Diagnosis is made with orthogonal radiographs of the tibia with CT scan often required to assess for intra-articular extension. Treatment generally consists of surgical open reduction and internal fixation (ORIF) versus intramedullary nail fixation.

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