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Edited By :- Dr. Bindesh D. Patel, PT
Deputy Registrar
P P Savani University
Prepared By:-Ummehani Mulla
Fracture of
Shaft of Humerus
• Common in any age
• Sustained from an indirect twisting or bending
force or FOOSH or by direct injury
Pathoanatomy
• Can be considered as a prototype because it
occurs in all pattern, may be closed or open
and may be traumatic or pathological
• May not be displaced
• May be displaced because of pull of Deltoid
• Distraction occurs due to gravity
Diagnosis
• Patient present with
classical signs and
symptoms of a fracture.
• May be wrist drop if radial
nerve is injured
• X-ray of whole arm
including shoulder and
elbow should be done.
Treatment
• Treatment is easy as some amount of
displacement and angulation is acceptable
because
– Limitation of motion goes unnoticed due to
multiaxial shoulder joint
– Shortening goes undetected
– Bone is covered with thick muscles so that
malunited muscle is not noticeable
• Strict immobilization is not necessary. Primary
aim of treatment is pain relief and prevention
of lateral angulation and distraction.
• Conservative method
1. U-slab method
2. Hanging cast
3. Chest arm bandage
• Operative method
1. Plate and screws
2. Intra medullary nailing
3. External fixation
Complication
1. Delayed and non-union
– Transverse fracture often go into it
– Major cause is distraction or inadequate
immobilization
– Proper immobilization is given in U-slab or
shoulder spica
– Open reduction and internal fixation is done
– For poor quality bone, intramedullary fibular
graft may be used.
2. Nerve Injury
– Radila nerve is common
– Neuropraxia
– Holstein Lewis fracture
– Wrist drop and sensory change
• Treatment
– Treatment depends on type of injury
– In most cases nerve recovers spontaneously
– In open cases exploration is required
– Tendon transfer is also done. Modified jone’s
transfer is most popular
– Muscle supplied by median and ulnar nerve are
used substituting wrist and finger extension and
thumb abduction-extension.
• Pronator Teres to Ext. Carpi Radialis Brevis
• Flex. Carpi Ulnaris to Ext. Digitorum
• Palmaris Longus to Ext. Pollicies longus
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4. Fracture of shaft of Humerus

  • 1. Edited By :- Dr. Bindesh D. Patel, PT Deputy Registrar P P Savani University Prepared By:-Ummehani Mulla Fracture of Shaft of Humerus
  • 2. • Common in any age • Sustained from an indirect twisting or bending force or FOOSH or by direct injury
  • 3. Pathoanatomy • Can be considered as a prototype because it occurs in all pattern, may be closed or open and may be traumatic or pathological • May not be displaced • May be displaced because of pull of Deltoid • Distraction occurs due to gravity
  • 4.
  • 5. Diagnosis • Patient present with classical signs and symptoms of a fracture. • May be wrist drop if radial nerve is injured • X-ray of whole arm including shoulder and elbow should be done.
  • 6. Treatment • Treatment is easy as some amount of displacement and angulation is acceptable because – Limitation of motion goes unnoticed due to multiaxial shoulder joint – Shortening goes undetected – Bone is covered with thick muscles so that malunited muscle is not noticeable
  • 7. • Strict immobilization is not necessary. Primary aim of treatment is pain relief and prevention of lateral angulation and distraction. • Conservative method 1. U-slab method 2. Hanging cast 3. Chest arm bandage
  • 8.
  • 9. • Operative method 1. Plate and screws 2. Intra medullary nailing 3. External fixation
  • 10. Complication 1. Delayed and non-union – Transverse fracture often go into it – Major cause is distraction or inadequate immobilization – Proper immobilization is given in U-slab or shoulder spica – Open reduction and internal fixation is done – For poor quality bone, intramedullary fibular graft may be used.
  • 11.
  • 12. 2. Nerve Injury – Radila nerve is common – Neuropraxia – Holstein Lewis fracture – Wrist drop and sensory change
  • 13. • Treatment – Treatment depends on type of injury – In most cases nerve recovers spontaneously – In open cases exploration is required – Tendon transfer is also done. Modified jone’s transfer is most popular – Muscle supplied by median and ulnar nerve are used substituting wrist and finger extension and thumb abduction-extension.
  • 14. • Pronator Teres to Ext. Carpi Radialis Brevis • Flex. Carpi Ulnaris to Ext. Digitorum • Palmaris Longus to Ext. Pollicies longus
  • 15.
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