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At least 1,189 records · Page 66Linked to original sources
PubMed1995

Bundle nailing of diaphyseal fractures of the humerus.

The principles of bundle nailing--jamming of the nails in the cortical window, jamming in the waist of the medullary cavity, spreading the bunch of nails in the metaphysis and filling up the conus of the medullary cavity with short nails-should be observed. Then this method of intramedullary osteosynthesis is of diaphyseal fractures with slight damage to the soft tissues is indicated ideally in the second to fifth sixth of the humerus. The complication rate is low. If there is a primary traumatic lesion of the radial nerve or if there are open fractures and/or multiple fractures in case of polytraumatized patients, operative stabilization is mandatory using plate osteosynthesis or external fixation.

Adolescent↗
PubMedDate not supplied

Supracondylar fractures of the humerus in children. A comparison between non-surgical treatment and minimum synthesis.

The authors propose a comparison between methods used to treat supracondylar fractures of the humerus in children. The study included: 33 patients treated at the Ist Orthopaedic Clinic in Padova by non-surgical reduction and thoracobrachial plaster, and 33 patients treated at the Division of Orthopaedics and Traumatology at the Treviso Hospital by minimum synthesis and brachiometacarpal plaster. Mean follow-up was 7 years. The results were classified based on the Lagrange and Rigault system and the following parameters were also considered: time of hospitalization, cost-benefit relationship, loss of reduction of the fracture, any dysmetria. The two methods are equal in terms of time required for healing, and axial deviations, which were always less than 15, although somewhat better results were observed in cases judged to be excellent, with hospitalization under 2.5 days, and when minimum synthesis was used.

Age Factors↗
PubMed1977

Supracondylar fractures of the humerus: the role of dynamic factors in prevention of deformity.

In a retrospective survey of eighty-two children with supracondylar fractures of the humerus, forty were found to have sufficient clinical and roentgenographic data to classify the fractures as varus or valgus, and to determine the carrying angles at end result. The initial displacement (varus or valgus) of the distal fragment correlated with the final carrying angle, but the use of internal fixation, the adequacy of reduction achieved and the duration of traction or immobilization did not. The sixteen varus supracondylar fractures immobilized with the forearm in supination had a mean varus deformity of about 16 degrees, whereas the eight immobilized in pronation had a varus deformity of only 3 degrees. The findings in the few valgus fractures suggested that the valgus angulation was less at follow-up if they had been immobilized in supination. Dissection of eight cadaver limbs and electromyographic studies of one normal limb suggested that the position of the forearm affects the result by altering muscle tension.

Adolescent↗
PubMed1977

Functional bracing of fractures of the shaft of the humerus.

We treated fifty-one cases of fracture of the shaft of the humerus with a functional method of treatment consisting of a plastic sleeve, individually molded or prefabricated. It maintained good alignment of the fragments and permitted rapid and uninterrupted osteogenesis. The early introduction of functional activity to the entire extremity appears to provide a desirable physiological environment conducive to rapid healing. Non-unions have not been encountered in nonpathological fractures. Healing time has been rapid, and there has been consistent restoration of motion of all joints prior to the completion of healing. The morbidity was minimum.

Adolescent↗
PubMed1996

Intraarticular distal humerus fractures. Factors affecting functional outcome.

In intraarticular fractures of the distal humerus, full functional recovery is difficult to obtain. Even if stable anatomic reconstruction of the articular surface is achieved by open reduction and internal fixation, nerve lesions, joint stiffness, and heterotopic bone formation may spoil the functional result. Ninety-nine consecutive fractures were treated by open reduction and internal fixation and studied retrospectively to determine factors influencing outcome. Followup examination of 77 cases showed 52% excellent and good late results. Twenty-six patients had nerve injuries. The rate of heterotopic bone formation was 49%. Open fractures and polytraumatized patients had less favorable results. Early operations within 24 hours resulted in significantly less heterotopic bone formation and better overall function that did delayed treatment. Careful examination of nervous deficits and early stable internal fixation with routine exposure of the ulnar nerve is therefore recommended in the management of this injury.

Adolescent↗
PubMed1996

[Surgical treatment for fracture of the proximal humerus].

Results of surgical treatment for proximal humerus fracture in 44 patients have been presented. The Neer classification served to establish fracture type. The preferred mode of treatment employed in 28 cases was stabilization of fragments with the use of Rush pins. This was sufficient for an early motion in the joint and no external immobilization was needed. In all cases operated with this method healing of the fracture was achieved; from among 25 followed-up patients good or excellent late results were found in 85%.

Adult↗
PubMed1996

[Four part valgus impacted fractures of the upper extremity of humerus: ilium graft reconstruction. Apropos of 8 cases].

PURPOSE OF THE STUDY: We present the results of an original technique for reconstruction of valgus-impacted humeral head using autologous iliac bone. MATERIAL AND METHODS: Between 1992 and 1993, 8 patients (average age 66 years, range 43 to 79 years) with four-part valgus impacted proximal humeral fractures were operated with the aim of preserving the humeral head. All fractures were treated with open reduction and were stabilized only with autologous bone. This procedure provided fixation without osteosynthesis. Using a deltopectoral approach the impacted segment of the humeral head was raised, the void was filled with autologous three-cortical iliac bone graft, and the tuberosities were relocated with the goal of anatomic reconstruction. The assessment included clinical examination including Constant's score, radiographic examination and MRI examination. Only one patient was not available for the review at follow-up evaluation (minimum 12 months, average 16 months). RESULTS: According to Constant's criteria, two results were excellent, two very good, one good, one fair and one patient were considered failure. Average Constant's score was 62; average score in comparison with the healthy side was 76 per cent. Radiographic findings showed in all cases healing and incorporation of the graft. MRI results showed only one asymptomatic partial avascular necrosis (14 per cent). DISCUSSION: This specific type of displaced four-part fracture of the proximal humerus which consists of valgus impaction of the head fragment without lateral displacement has a rate of avascular necrosis lower than that of other displaced four-part fractures. Blood supply of the articular segment is maintained via the periosteum extending to the medial part of the anatomic humeral neck. These data authorized the authors to propose a new conservative treatment for four-part valgus impacted proximal humeral fractures.

Adult↗
PubMed1996

[Complications of supracondylar fractures of the humerus in children].

The supracondylar fracture of the humerus is the commonest type of elbow fracture in children. The peak incidence for this injury is between 5 and 10 years of age. The complications of these displaced fractures remain challenging problems. The early complications are mostly the neuro-vascular injuries. The difficulty in maintaining the reduction and ultimately the cubitus varus is the most frequent long-term complication with an incidence ranging from 3 to 57%. Adequate reduction and pinning has dramatically decreased this incidence. This paper describes these complications and their treatments.

Bone Nails↗
PubMedDate not supplied

Humerus shaft fractures in young children: accident or abuse?

We performed a retrospective review of 34 humerus shaft fractures (HSFs) in children younger than 3 years to determine the frequency of child abuse in young children with this injury. Data were obtained from hospital records (including previous and subsequent emergency, clinic, and inpatient notes), radiographs, and county childprotective services. Cases were reviewed independently by four physicians and were classified as probable abuse, probable not abuse, and indeterminate. Only 18% were classified as probable abuse. The history and findings other than the fracture itself were critical in establishing cause. Neither age nor fracture pattern is pathognomonic of abuse, but suspicion should remain high. A detailed history, complete physical examination, and appropriate radiographic investigation are required in every case either to make the diagnosis of abuse or to avoid the trauma of a false accusation.

Accidents↗
PubMed1997

A retrospective study on elbow function after internal fixation of intercondylar fracture of adult humerus.

Between 1989 and 1993, 20 intercondylar fractures of the distal humerus were treated by open reduction, internal fixation and early postoperative mobilisation. One patient died on the third postoperative day as a result of multiple injuries, leaving 19 patients for evaluation. The mean follow-up period was 4.1 years (range 2.0 to 6.7 years). According to the Muller system, there were 7 type C1 and 12 type C2 fractures. Using the Jupiter criteria, 6 elbows were rated as excellent, 9 good and 4 fair. Complications included late ulnar neuritis in one patient and wound infection in another patient.

Adolescent↗
PubMed1997

[T-plate osteosynthesis in dislocated proximal humerus fractures].

From 1988 through 1995 we operated 48 patients with dislocated humeral fractures using the T-Plate (median age 66 years [20 to 90 years], 32 male, 16 female). After a median 22 months (9 to 60 months) 33 patients were followed up clinically and radiologically. Six patients had suffered a 2-part fracture, 17 a 3-part fracture, and 10 a 4-part fracture. Judged by the Constant score 6 patients reached a very good result, 8 had a good result, 4 a satisfactory and 15 a poor result. Radiologically we saw an arthrosis in 31%, an axial deviation in 50%, and a dislocation of the fragments in 72%. The rate of necrosis of the humeral head was 39%. MRI (17 patients) provided additional relevant information about soft tissue and bone quality and is valuable in the early detection of necrosis of the humeral head. Functionally poor results correlated rather to dislocated fragments and persisting axial deviation than to the type of fracture or the necrosis of the humeral head. The T-plate osteosynthesis is one way to treat dislocated fractures of the proximal humerus, if early operation, correct reposition, and biological principles are respected.

Adult↗
PubMed1997

[Prosthetic humeral head replacement in dislocated humerus multi-fragment fracture in the elderly--an alternative to minimal osteosynthesis?].

In a prospective randomised study, comprising 30 aged patients with fractures of the proximal humerus (4-fragment fractures according to Neer) minimal osteosynthesis was compared to primary endoprosthetic replacement. The Constant score was used for evaluation during follow-up. After one year the results were similar in both groups. There were two complications necessitating revision surgery among the patients with minimal osteosynthesis and in four cases the implants had to be removed. In the group with primary endoprosthetic repair neither complications nor revision surgery occurred. Primary endoprosthetic replacement for the treatment of proximal humeral fractures appears as a therapeutic option with a low complication rate and a satisfying functional outcome. In older patients we need a safe mode of therapy permitting early mobilization and quick discharge from the hospital back to the patient's home. Endoprosthetic replacement fulfils these demands since it resembles a "one time surgery" without the risk of revision surgery for implant loosening, pseudarthrosis or ischemic necrosis of the humeral head.

Activities of Daily Living↗
PubMed1976

Fractures of the humerus in children.

Fractures of the humerus above the distal epiphysis are not common fractures in children. Treatment should be directed toward maintenance of alignment with healing expected without fail. Contrary to experience with adults with the same fractures, children seldom have residual functional or cosmetic problems if one aligns the fractures and protects the healing process.

Adult↗