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At least 397 records · Page 22Linked to original sources
PubMed1994

Median nerve palsy after operative treatment of intraarticular distal humerus fracture with intact supracondylar process.

A case is presented in which acute median nerve palsy developed within 24 h after surgical treatment of an intraarticular distal humerus fracture in a patient with an intact supracondylar process. This nerve compression responded favorably to anterior decompression. If this combination (intraarticular distal humerus fracture and supracondylar process) is encountered, prophylactic resection of the process and ligament seems indicated, if possible through the fracture fixation exposure. If not, close postoperative neurologic monitoring is essential.

Aged↗
PubMed1994

Open reduction and internal fixation of three- and four-part fractures of the proximal humerus.

Thirty-one patients, ranging in age from 19 to 62 years (average, 55 years), were evaluated an average of six years seven months (range, one to 12 years) after open reduction and internal fixation of a three- or four-part fracture of the proximal humerus. Six patients had an associated dislocation of the humeral head. A modified cloverleaf plate was used in 26 cases and an AO T-plate in five cases. All fractures healed. No avascular necrosis of the humeral head was observed at follow-up examination. Twenty-three patients had an excellent result, two had a good result, and six had a fair result. Open reduction and internal fixation of three- and four-part fractures of the proximal humerus are indicated as initial treatment, even before the use of a prosthetic replacement, which should be recommended only for elderly patients with osteoporotic bones.

Adult↗
PubMed1976

Developmental humerus varus.

Humerus varus, the upper extremity analogue of coxa vara, may be found in association with, and probably as a consequence of hematologic, infectious metabolic, genetic and neurologic disorders. No matter what the etiology, there is a similar pattern of development and progression of the deformity. The medial region of the proximal humeral physis either develops slowly or failed to develop, while the lateral region develops more rapidly, causing varus rotation of the proximal humeral epiphysis and physis. In the more extreme cases, the lateral region of the growth plate is almost parallel to the longitudinal axis of the shaft. In many cases there is a medial lucency, adjacent bony epiphyseodesis, and significant shortening of the humerus. Although abduction is usually decreased, major functional impairment is unusual even in the dominant arm.

Adolescent↗
PubMed1993

Applications of the Ilizarov method in the humerus. Lengthenings and nonunions.

Between 1982 and 1992, Ilizarov's method was used in 68 lengthenings and 29 nonunions of the humerus. Special rings along with the arches similar to those used for femoral lengthening were used to allow unrestricted motion at the elbow and shoulder. These patients were followed for an average of 5.1 years. In cases of lengthening, average length achieved was 9 cm, with duration of treatment being 5 to 14 months. Overall results in most cases were excellent. In cases of nonunion, the duration of treatment averaged 226 days. Of the 29 nonunions, 25 healed. Our results, including no major complications, support the continued use of Ilizarov's technique in humeral lengthening and nonunions of the humerus.

Adolescent↗
PubMedDate not supplied

Seidel locked nailing for the treatment of unstable fractures and nonunion of the humerus.

The results of treatment by Seidel locked nailing in 13 recent fractures and 4 nonunions of the humerus are reported. The feature common to all of the fractures was instability consequent to comminution or in the site of the fracture center. The 4 nonunions were originally fractures synthesized by Rush intramedullary nailing. The surgical method used an entry approximately 1 cm from the greater tuberosity through a well-vascularized area of the rotator cuff. All of the cases achieved consolidation and in 70% of the patients results were excellent with complete recovery of range of movement of the shoulder. Thus, the Seidel nail appears to be an intramedullary means of synthesis particularly suited to the treatment of unstable fractures and nonunion of the humerus because it guarantees stability, especially in rotation, superior to any other intramedullary means of synthesis.

Adult↗
PubMed1997

Abscess on the lateral epicondyle of the humerus as a cause of lameness in a horse.

An 18-month-old 450-kg [990-lb] sexually intact male Holsteiner was evaluated for lameness of the left forelimb of 3-months' duration. We were unable to localize the site of lameness, using intra-articular and perineural anesthesia, and radiography of the shoulder and cubital joint (elbow) did not reveal radiographic abnormalities. Nuclear scintigraphy was performed. An increase in radio-isotope uptake was evident at the lateral epicondyle of the left humerus. Radiographs of the region 3 weeks later revealed a 1.5-cm focal lucency surrounded by a 1.0-cm rim of necrotic bone. The lesion was consistent with an encapsulated osteomyelitis or bone abscess. Surgical correction was performed, using general anesthesia, and involved a lateral approach to the epicondyle of he humerus. Cyst contents were removed with curettage, and the cavity was packed with cancellous bone harvested from the tuber coxae. A coagulase-negative Staphylococcus organism was cultured from the abscess. The horse was sound 3 weeks after surgery, and radiography 10 months later revealed complete ossification and adjacent sclerosis at the surgical site. Solitary cystic lesions of long bones may represent bone abscesses capable of causing lameness in horses. Nuclear scintigraphy can provide early diagnostic capability. Curettage and cancellous bone grafting are indicated for treatment of bone abscesses.

Abscess↗
PubMed1976

[Total replacement of humerus including shoulder and elbow joints].

A case of total alloplastic replacement of the humerus, including the neighboring joints, is reported. The method may be used for treatment of large defects of the humerus due to tumor, osteomyelitis, or trauma. The alloplastic replacement seems superior to autoplastic fibula transplantation.

Bone Neoplasms↗
PubMed1976

[Causes and treatment of delayed callusformation and pseudarthrosis following fractures of the shaft of the humerus (author's transl)].

In the OHH, during the years 1969 to 1974, 28 patients were operatively treated because of delayed callusformation or pseud-arthrosis, following a fracture of the shaft of the humerus. It was possible to inquire about and to re-examine 20 patients. The operative treatment had, when possible been achieved by osteosynthesis through plates (25 cases). Each of the so treated cases lead to healing of the bone, additional nerve lesion did not in one case occur because of the operation. Objectively seen, there existed in 7 patients a slight, final restriction of movements, for the abduction and outside rotation in the shoulder joint. 6 patients complained of being sensitive to weather changes. The different treatment method of the fracture of the humerus and pseudarthrosis was discussed.

Aged↗
PubMed1980

The treatment of fractures of the proximal humerus.

Fractures of the proximal humerus, which can not be kept in place after reposition--and therefore not acceptable for conservative treatment--can be sufficiently fixed by a thin and long Rush-pin percutaneously introduced. So the damaged arm can be moved early. No inflammation and no pseudarthrosis was observed in 124 cases. The follow up examination of 98 patients after 6 to 12 months revealed good results. In 4 children the fractured neck of the humerus could not be reposed into a proper position (Interposition of periosteum and joint capsule). After open reduction fixation was performed by Kirschner's wires. We observed fast and complete healing in all cases.

Adolescent↗
PubMed1988

Median nerve entrapment in bone after supracondylar fracture of the humerus. Case report.

A case is reported, where the median nerve was entrapped in a supracondylar humerus fracture, not preventing closed reduction. As serious impairment of the median nerve function did not improve within ten weeks, the nerve was explored and dissected out of the humerus using microsurgical technique, leading to complete recovery of the neural function. The purpose of this report is to draw attention to the fact, that the median nerve can be enclosed in supracondylar fractures reducable to good position and further, that delicate dissection of the nerve out of the bone does not necessitate sacrifice of its continuity.

Child↗
PubMed1991

Osteochondritis dissecans of the trochlea of the humerus.

Osteochondritis dissecans is a transchondral fracture. Localization to the elbow is rare when it is usually located in the capitellum of the humerus or the radial head. Osteochondritis of the trochlea of the humerus is described in a 12 year old X-ray and MRI.

Child↗
PubMed1986

[Injuries of the distal epiphysis of the humerus in the period of growth].

From 1978 to 1983 in the Orthopedic University Clinic (Oskar-Helene-Heim, Berlin) 75 children with fractures of the distal humerus received medical treatment. The results of 25 intra-articular fractures of the distal humerus in children (ten fractures of the radial condyles, eight fractures of the ulnar epicondyles, three Y-fractures of the condyles, two luxations with additional flake fractures, one fracture of the ulnar condyle) will be reported. The frequency of remaining complications like valgus and varus deformities, pseudarthroses, posttraumatic osteochondroses and "fish tail" deformities are described. The possible mechanism of such developing deformities is discussed. The resulting consequences for the surgical treatment in the future are also discussed.

Adolescent↗
PubMed2005

[Internal fixation of proximal humerus fractures].

BACKGROUND: Intramedullary nails and angle-fixed plates have recently been used in proximal humerus fractures. Rigid implants might be associated with an increased risk of failure in osteoporotic conditions. METHODS: Unstable fractures of the surgical neck were created in 24 pairs of human humeri. The biomechanical properties of four implants were analysed. These were a nail with conventional interlocking (PHN-K), a nail with spiral blade interlocking (PHN-S), the T-plate, and an internal fixator with elastic screw properties (reference). The specimens were subjected to axial loading and torque. Stiffness, plastic deformity, and load to failure were assessed. RESULTS: The PHN-S was stiffer than the internal fixator. The PHN-K and T-plate were stiffer only during torque. Less subsidence was observed for the PHN-S. This implant failed at higher loads than the other implants. CONCLUSIONS: The PHN-S offers biomechanical advantages in unstable fractures of the surgical neck of the humerus. Elastic implant properties, however, are disadvantageous.

Aged↗
PubMed2006

[Fracture of the proximal humerus in children and adolescents. The most overtreated fracture].

BACKGROUND: There is great uncertainty among trauma surgeons regarding the correct treatment of rare proximal humerus fractures in children and adolescents, in spite of the great potential of the proximal humeral epiphysis for self-correction, even in cases of gross malalignment. METHODS: Over a span of 6 years, we treated 52 children and adolescents with closed proximal humerus fractures, 45 of whom had no other injuries. In only three cases did we see an indication for operative treatment at our institution. Operations on another three were performed elsewhere. Forty two patients were available for follow-up exams. RESULTS: They all had good or very good results with regard to fracture healing (constant score) independently of age, sex, fracture morphology, and treatment. CONCLUSIONS: We believe it is particularly important to discuss therapy concepts with parents and the involved outpatient physicians in order to avoid unnecessary and stressful operations.

Adolescent↗
PubMed1997

[Post-traumatic anterior interosseous nerve syndrome after supracondylar humerus fracture in a child].

The interosseus anterior syndrome is a rare nerve compression syndrome that concerns only the motor branch of the median nerve. It is evidenced by paralysis of the M. flexor pollicis longus and M. flexor digitorum profundus II with weakness of flexion of the terminal joint of the thumb and index finger but without sensory loss. From the surgical point of view this complication has special importance because of pediatric fractures of the distal humerus. In this paper we discuss the differential diagnosis, therapy and prognosis of this nerve injury by presenting an illustrative case of a 7-year-old boy suffering a supracondylar fracture of the humerus with a post-traumatic anterior interosseus nerve syndrome.

Child↗
PubMed2002

[The BEHAC nail--a new intramedullary implant for managing 2-stage fractures of the humerus].

The BEHAC-nail is a new implant for the treatment of complex humeral fractures, particularly for segmental fractures. It is an elastic intramedullary implant that is inserted retrograde into the distal humerus. The special feature of this nail is its proximal "loop design" which reduces the implant penetration at the proximal fixation site in the subchondral area of the humeral head in comparison to implants with tips such as Rush pins or Hackethal's nails. Thus, the risk of nail migration and perforation of the humeral head is less with the BEHAC-nail than with other nails. Another advantage of the "loop design" is that the humeral head fragment can be fixed adequately. Even short proximal fragments can be stabilized with this design. In contrast a short humeral head fragment cannot be held with implants like the UHN, HVN or Seidel's nail. The BEHAC-nail is a useful implant for segmental fractures of the humerus.

Equipment Design↗
PubMed2004

[Evaluation of shoulder arthroplasty in treatment of four-fragment fractures of the proximal humerus].

The dislocated four-fragment fracture of the proximal humerus is a problematic fracture. In this study we evaluated shoulder function after implantation of a shoulder hemiprosthesis of the anatomical generation. The evaluation was based on a case-control study in which the following information was gathered: epidemiology, Constant-Murley score, compliance score, radiological results, and a summary of complications. Twenty shoulder prostheses were implanted between September 2000 and August 2002. After an average follow-up time of 14 months, the average Constant score was 52. The score for the opposite shoulder was 91 points. The function found to be most limited was shoulder movement. The subjective estimation of shoulder function had a mean value of 49% and correlated with the Constant score. Fourteen of the patients exhibited a postoperative defect in the tuberculum majus. Implantation of shoulder hemiprostheses allows treatment of four-fragment fractures of the humerus head in older patients, whereby limitations of mobility and function are to be expected.

Aged↗
PubMed2004

[Marburg shoulder radiography splint (MSR splint) for standardized and high quality plain film radiography in fractures of the proximal humerus].

To ensure safe, quick, pain-relieving, standardized, and reproducible high quality plain film radiography in fractures of the proximal humerus, the MSR splint was introduced into clinical practice. With the rectangular and completely radiolucent splint the shoulder radiographs are obtained in supine position by a sole radiographer. Two radiographs are taken in projection at 90 degrees to one another: the true anteroposterior and axillary views, the most important views for fracture visualization and assessment. The smooth flat bottom part of the splint glides easily across the X-ray table below the injured shoulder. The arm lying on the chest is carefully rotated externally up to the neutral position and placed in the splint, then fixed with Velcro fastening with the forearm supinated. The splint is adjusted to the patient for the anteroposterior view which is taken with the central ray directed at the coracoid process and perpendicularly on the film cassette. For the axillary view the MSR splint holding the upper extremity is carefully swiveled into a 80-90 degrees abduction position. Even in cases of comminuted fractures this maneuver is not painful for the patients. The X-ray tube is put into a horizontal position with the central ray pointing to the humeral head in an angle about 25 degrees to the long body axis. The cassette is placed upright in touch with the shoulder girdle. In our institution the MSR splint is not only routinely used for diagnosing fractures of the proximal humerus but also for radiological follow-up controls.

Equipment Design↗