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Humerus Fracture

This document discusses humerus fractures, including: - The humerus bone is located in the upper arm between the shoulder and elbow. - Fractures can be classified based on cause, displacement, relationship to the external environment, and pattern. - Treatment involves splinting or bracing for non-operative fractures, while operative treatment is needed for fractures that cannot be reduced or maintained through closed means.

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261 views

Humerus Fracture

This document discusses humerus fractures, including: - The humerus bone is located in the upper arm between the shoulder and elbow. - Fractures can be classified based on cause, displacement, relationship to the external environment, and pattern. - Treatment involves splinting or bracing for non-operative fractures, while operative treatment is needed for fractures that cannot be reduced or maintained through closed means.

Uploaded by

Hęñøķ Bęŕhãñę
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd
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Humerus fracture

By Moges G.
November 28/2018
Fracture of humerus
• The humerus is upper arm bone between
shoulder and elbow.
• Proximally, the humerus is roughly cylindrical in
cross section, tapering to a triangular shape
Distally.
• It is only for a short distance near the lateral
supracondylar ridge that the nerve is direct contact
with the humerus and pierces lateral intermuscular
septum
Fracture
• A fracture is a break in the continuity of a bone.
• Fracture can be classified on the basis of aetiology,
the relationship of the fracture with the external
environment, the displacement of the fracture, and
the pattern of the fracture.
 ON THE BASIS OF AETIOLOGY
 Traumatic fracture:
 Pathological fracture:
 Stress Fracture:
Classification of fracture
 ON THE BASIS OF DISPLACEMENTS
• Displaced fracture: A fracture may be displaced.
• The factors responsible for displacement are: (i)
the fracturing force;
(ii) the muscle pull on the fracture fragments; (iii)
the gravity.
• Un displaced fracture: These fractures are easy to
identify by the absence of significant
displacement.
ON THE BASIS OF RELATIONSHIP WITH
EXTERNAL ENVIRONMENT
• Closed fracture: A fracture not
communicating with the external environment,
• the overlying skin and other soft tissues are
intact
• Open fracture: A fracture with break in the
overlying skin and soft tissues, leading to the
fracture communicating with the external
environment
ON THE BASIS OF PATTERN
• Transverse fracture: the fracture line is perpendicular to
the long axis of the bone.
• Oblique fracture: the fracture line is oblique. Such a
fracture is caused by a bending force.
• Spiral fracture: the fracture line runs spirally in more than
one plane. Such a fracture is caused by a primarily twisting
force.
• Comminuted fracture: a fracture with multiple fragments.
• Segmental fracture: In this type, there are two fractures in
one bone, but at different levels.
MECHANISM OF INJURY
• Direct trauma is the most common especially MVA
• Indirect trauma such as fall on an outstretched
hand
• Fracture pattern depends on stress applied
 Compressive- proximal or distal humerus
 Bending- transverse fracture of the shaft
 Torsional- spiral fracture of the shaft
• Torsion and bending- oblique fracture usually
associated with a butterfly fragment
CLINICAL FEATURES
• Pain.
• Deformity.
• Bruising.
• Crepitus.
• Abnormal mobility
• Swelling.
• Any neurovascular injury
INVESTIGATION

• Skin integrity .
• Examine the shoulder and elbow joints and
the forearm, hand, and clavicle for associated
trauma.
• Check the function of the median, ulnar, and,
particularly, the radial nerves.
• Assess for the presence of the radial pulse.
Con..
• Radiographs
• CT scan
• MRI scan
• Nerve conduction studies
FRACTURE HEALING
STAGES IN FRACTURE HEALING OF CORTICAL
BONE
• Stage of haematoma
• Stage of granulation tissue
• Stage of callus
• Stage of remodelling (formerly called
consolidation)
• Stage of modelling (formerly called remodelling)
FACTORS AFFECTING FRACTURE HEALING

• Age of the patient


• Type of bone
• Pattern of fracture
• Disturbed pathoanatomy
• Type of reduction
TREATMENT
• Treatment of a fracture can be considered in
three phases
• Phase I - Emergency care
• Phase II - immobilization care
• Phase III - Rehabilitation
Cont...
• At the site of accident: Emergency care of a
fracture begins at the site of the accident. In
principle, it consists of RICE, which means:
• Rest to the part, by splinting.
• Ice therapy, to reduce occurrence of swelling
• Compression, to reduce swelling
• Elevation, to reduce swelling
Cont...
Fundamental principles of fracture treatment:
• The three fundamental principles of treatment
of a fracture are: (i) reduction; (ii)
immobilisation; and (iii) preservation of
functions.
NON OPERATIVE
• Splinting:
◦ Fractures are splinted with a hanging splint, which
is from the axilla, under the elbow, positioned to
the top of the shoulder .
◦ The U splint.
◦ The splinted extremity is supported by a sling.
◦ Immobilization by fracture bracing is continued for
at least 2 months or until clinical and radiographic
evidence of fracture healing is observed.
OPERATIVE
INDICATIONS
• Fractures in which reduction is unable to be achieved or
maintained.
◦ Fractures with nerve injuries after reduction manoeuvres'.
◦ Open fractures.
◦ Intra articular extension injury.
◦ Neurovascular injury.
◦ Impending pathologic fractures.
◦ Segmental fractures.
◦ Multiple extremity fractures

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