Journal of Musculoskeletal Trauma

Delayed Brachial Artery Occlusion after Humeral Shaft Open Fracture: A Case Report: Chul Hyun Cho, Ki Cheor Bae, Kyung Jae Lee, Si Wook Lee; J Korean Fract Soc 2012;25(2):146-149. Published online April 30, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.2.146

Although vascular injury after humeral fracture is very rare, it is a complication that has serious sequelae. It has been associated with proximal humeral fracture or shoulder dislocation in adults and humeral supracondylar fracture in children. However, delayed brachial artery occlusion after humeral shaft fracture has never been reported worldwide. Nevertheless, delayed brachial artery occlusion after humerus shaft fracture has the potential to cause serious complications in the short term as well as long term; therefore, it is essential to provide accurate diagnosis and prompt treatment. We report a case of delayed brachial artery occlusion after humeral shaft open fracture that was successfully treated with early diagnosis as well as effective treatment.

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Delayed presentation of brachial artery injury following fracture shaft humerus; whether amputate or salvage: A series of two cases
Bhanu Sharma, Sibashish Metia, Kavish Kapoor, Pankaj Poswal
Journal of Orthopedics, Traumatology and Rehabilitation.2018; 10(2): 137. CrossRef

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The Fate of Butterfly Fragments in Extremity Shaft Comminuted Fractures Treated with Closed Interlocking Intramedullary Nailing: Ki Chan An, Yoon Jun Kim, Jang Suk Choi, Seung Suk Seo, Hi Chul Gwak, Dae Won Jung, Dong Woo Jeong; J Korean Fract Soc 2012;25(1):46-51. Published online January 31, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.1.46

Abstract PDF

PURPOSE
For conservative treatment of shaft fractures, the butterfly fragments that were somewhat larger in the closed intra-medullary (IM) nailing. The results of treatment were monitored using radiography separately for the weight-bearing femur and non-weight-bearing humerus.
MATERIALS AND METHODS
27 from Group I and 31 from Group II. In the two groups, the displacement and angulation changes in the fragments, and the degree of improvement of these two factors, were compared using follow-up radiography.
RESULTS
The mean angulation of fragments in Groups I and II were 9.2degrees and 9.6degrees, and the mean degree of displacement of the fragments in Groups I and II were 16.7 mm and 21.2 mm, respectively. Follow-up radiography showed that the above factors improved in both groups. The degree of displacement was significantly lower in the normal cases than in the complicated cases (p=0.001).
CONCLUSION
Displacement and angulation gradually improved in both groups. It was found that the degree of displacement after the initial reduction is more important than the influence of anatomical position or weight bearing. This indicates that care should be taken when inserting IM nails to prevent displacement or angulation.

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Risk Factors for Failure of Nonsurgical Management of Ulnar Shaft Fractures
Carew C. Giberson-Chen, Cassandra M. Chruscielski, Dafang Zhang, Philip E. Blazar, Brandon Earp
The Journal of Hand Surgery.2025; 50(4): 497.e1. CrossRef
The impact of the third fragment features on the healing of femoral shaft fractures managed with intramedullary nailing: a radiological study
Giovanni Vicenti, Massimiliano Carrozzo, Vincenzo Caiaffa, Antonella Abate, Giuseppe Solarino, Davide Bizzoca, Roberto Maddalena, Giulia Colasuonno, Vittorio Nappi, Francesco Rifino, Biagio Moretti
International Orthopaedics.2019; 43(1): 193. CrossRef
Reply to “Letter to the Editor on: The impact of the third fragment features on the healing of femoral shaft fractures managed with intramedullary nailing: a radiological study”
Giovanni Vicenti, Massimiliano Carrozzo, Davide Bizzoca, Biagio Moretti
International Orthopaedics.2019; 43(6): 1545. CrossRef
Letter to the Editor on “The impact of the third fragment features on the healing of femoral shaft fractures managed with intramedullary nailing: a radiological study”
Shih-Jie Lin, Kevin Liaw, Tsan-Wen Huang
International Orthopaedics.2019; 43(6): 1543. CrossRef
The impact of the third fragment features on the healing of femoral shaft fractures managed with intramedullary nailing: a radiological study
Giovanni Vicenti, Massimiliano Carrozzo, Vincenzo Caiaffa, Antonella Abate, Giuseppe Solarino, Davide Bizzoca, Roberto Maddalena, Giulia Colasuonno, Vittorio Nappi, Francesco Rifino, Biagio Moretti
International Orthopaedics.2018;[Epub] CrossRef
Comparison of the Result of the Intramedullary Nail Fixation and Plate Fixation in Humeral Shaft Fracture with Butterfly Fragments
Duk-Hwan Kho, Hyeung-June Kim, Byoung-Min Kim, Hyun-Ryong Hwang
The Korean Journal of Sports Medicine.2016; 34(2): 120. CrossRef
Clinical and Radiographical Follow-up for Residual Displacement of Fracture Fragments after Interlocking Intramedullary Nailing in Humeral Shaft Fractures
Jae-Kwang Yum, Dong-Ju Lim, Eui-Yub Jung, Su-Een Sohn
The Journal of the Korean Shoulder and Elbow Society.2013; 16(2): 107. CrossRef

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Treatment of Humeral Shaft Fracture with Retrograde Flexible Nail: Phil Hyun Chung, Chung Soo Hwang, Suk Kang, Jong Pil Kim, Young Sung Kim, Sung Pock Park, Kwang Uk An; J Korean Fract Soc 2006;19(3):340-345. Published online July 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.3.340

Abstract: PURPOSE
To evaluate and report the clinical and radiological results of the intramedullary fixation by retrograde flexible nail in the humeral shaft fracture.
MATERIALS AND METHODS
From July 2002 to May 2005, seventeen cases who had the humeral shaft fracture were treated with the intramedullary fixation by retrograde flexible nail. Fifteen cases were followed up and the clinical and radiological results were analyzed.
RESULTS
All of the cases had satisfactory fracture union, and none of the patient had limitation in shoulder or elbow joint movement, and shoulder or elbow joint pain, and average ASES was 42.86 point. There was 1 case of delayed union, and 3 cases of distal nail displacement. Another severe complications were not occurred.
CONCLUSION
Intramedullary fixation by retrograde flexible nail is one of the effective method in the humeral shaft fracture without nerve or vessel injuries, and also can avoid the complication of wide soft tissue incision or rotator cuff injury.

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Nonunion of the Humerus Shaft: Tae Seok Nam, Ji Won Choi, Ju Hyun Kim, Soung Yon Kim, Jung Jae Kim, Jae Myeung Chun; J Korean Fract Soc 2005;18(3):294-298. Published online July 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.3.294

Abstract PDF

PURPOSE
To evaluate the cause and treatment results of nonunion of humerus shaft fractures.
MATERIALS AND METHODS
39 cases were treated for humerus shaft nonunion between February 1990 and May 2002. The presence of open wounds, initial treatment modality after injury, treatment method for the nonunion and time to union were studied using medical records. The fracture type and appropriateness and problems of the initial surgical treatment were reviewed. Also, Pain and functional recovery in daily living were evaluated in the outpatient clinic, after surgery for nonunion.
RESULTS
Amongst the 30 cases, transverse fracture was the most common with 19cases. Most of 29 cases, initially surgically treated, revealed incorrect selection of the internal fixator or technical errors. For surgical treatment of nonunion, open reduction and internal fixation with cancellous bone graft was performed, most commonly, in 36 cases (92.3%). All cases showed clinical and radiographic union at an average of 13.3 weeks. More than 90% of the patients replied minimal pain and excellent functional recovery of daily living at final follow-up.
CONCLUSION
If treated with surgery by correct selection of internal fixation methods and accurate technical skills, nonunion incidence can be reduced.

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Comparing the Use of Single and Double Interlocking Distal Screws on a Polarus Intramedullary Nail for Humeral Shaft Fractures
Hee Seok Yang, Jeong Woo Kim, Hong Je Kang, Jung Hyun Park, Yong Chan Lee, Kwang Mee Kim
Clinics in Shoulder and Elbow.2015; 18(2): 91. CrossRef
Clinical and Radiographical Follow-up for Residual Displacement of Fracture Fragments after Interlocking Intramedullary Nailing in Humeral Shaft Fractures
Jae-Kwang Yum, Dong-Ju Lim, Eui-Yub Jung, Su-Een Sohn
The Journal of the Korean Shoulder and Elbow Society.2013; 16(2): 107. CrossRef
The Fate of Butterfly Fragments in Extremity Shaft Comminuted Fractures Treated with Closed Interlocking Intramedullary Nailing
Ki-Chan An, Yoon-Jun Kim, Jang-Suk Choi, Seung Suk Seo, Hi-Chul Gwak, Dae-Won Jung, Dong-Woo Jeong
Journal of the Korean Fracture Society.2012; 25(1): 46. CrossRef

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The Treatment Of Humeral Shaft Fracture With Rertograde Ao Unreamed Humeral Nail: Tae Woo Park, Sung Do Cho, Young Sun Cho, Bum Soo Kim, Sogu Lew, Moon Chan Kim, Ki Young Kim; J Korean Soc Fract 2002;15(3):398-403. Published online July 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.3.398

Abstract PDF: PURPOSE
To evaluate the results of the treatment of humeral shaft fractures using retrograde AO Unreamed Humeral Nail(UHN).
MATERIALS AND METHOD
From Apr. 1998 and Aug. 2001, 18 humeral shaft fractures were treated with retrograde AO UHN. All fractures were classified according to the AO classification. The results were analyzed by bony union time, range of motion and complication.
RESULTS
There were eleven cases of A3, two B2, one B3, four A2 humeral middle shaft fractures according to the AO classification. The mean bony union time was 12.2 weeks(range;9-16 weeks). All patients regained full range of motion of the shoulder joint and the elbow joint but 2 patients with intraopenatively ruptured capsule had transient elbow motion limitation. Complications were iatrogenic fractures at the entry portal in 2 patients(15%), transient shoulder pain in 4 patients(30.7%), nonunion in 1 patient(7.6%), required bone graft and internal fixation after removal of the nail at 13 months postoperatively.
CONCLUSION
The treatment of humeral shaft fracture with retrograde AO unreamed humeral nail is one of the good options to reduce the rate of non-union or delayed union by compression effect if the intraoperative errors is prevented.

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Postoperative Functional Assessments in Adult Humerus Shaft Fractures -Comparison Among Plates and Screws, Intramedullary Nail and External Fixator-: Sang Wook Bae, Woo Jin Kim, Baik Young Song, Nam Hong Choi, Jeong Hoon Lee; J Korean Soc Fract 2001;14(2):228-235. Published online April 30, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.2.228

Abstract PDF

PURPOSE
To assess postoperative functional outcomes among plates, intramedullary nails and external fixators in adult humeral shaft fractures, including limitation of motion in shoulder and elbow, pain in activities of daily living. MATERIAL AND METHODS: 24 cases treated with plates and screws, 19 cases with antegrade intramedullary nails and 13 cases with external fixators were analyzed in terms of limitation of motion, postoperative pain and activities in daily living.
RESULTS
There was no statistical difference in the range of motion of shoulder and elbow among three groups. VAS(visual analogue scale) which expressed postoperative pain in the affected site was lowest in the group treated with plates and screws. ASES score(American shoulder and elbow surgeons'score) which expressed the activities of daily living was investigated the highest in the group treated with plates and screws, and the differences of VAS and ASES score among three groups have statistical significances.
CONCLUSION
The most satisfactory results were obtained in the group treated with plates and screws.

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Minimal Invasive Plate Osteosynthesis versus Conventional Open Plating in Simple Humeral Shaft Fracture (AO Type A, B1, B2)
Boseon Kim, GwangChul Lee, Hyunwoong Jang
Journal of the Korean Fracture Society.2017; 30(3): 124. CrossRef
Minimally Invasive Plate Osteosynthesis Using a Screw Compression Method for Treatment of Humeral Shaft Fractures
Sang-Hun Ko, Jae-Ryong Cha, Chae Chil Lee, Yong Tae Joo, Kyeong Su Eom
Clinics in Orthopedic Surgery.2017; 9(4): 506. CrossRef
Comparative Analysis of the Result of Minimally Invasive Anterior Plating and Open Reduction and Internal Fixation in Humerus Shaft Simple Fracture
Sang-Hun Ko, Chang-Gyu Choe, Ju-Hyung Lee
Clinics in Shoulder and Elbow.2015; 18(2): 75. CrossRef
The Treatment of Humerus Shaft Simple Fracture by MIPO Technique
Sang-Hun Ko, Sun-Ho Lee, Bum-Keun Cho
The Journal of the Korean Shoulder and Elbow Society.2013; 16(1): 27. CrossRef
A Separate Approach and Cephalo-Diaphyseal Plate Fixation for the Comminuted Metadiaphyseal Fractures of the Proximal Humerus
Sung-Weon Jung
Journal of the Korean Fracture Society.2013; 26(1): 8. CrossRef
Surgical Treatment of Pathologic Humeral Fracture
Ho Jung Kang, Byoung Yoon Hwang, Jae Jeong Lee, Kyu Ho Shin, Soo Bong Hahn, Sung Jae Kim
Journal of the Korean Fracture Society.2010; 23(2): 187. CrossRef
Result of Interlocking Intramedullary Nailing for Humeral Shaft Fracture Evaluation of Post-operative Shoulder Function
Seung Rim Park, Tong Joo Lee, Ryuh Sub Kim, Kyoung Ho Moon, Dong Seok You
Journal of the Korean Fracture Society.2007; 20(2): 166. CrossRef

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A Comparison of Plate Fixation with Intramedullary Nailing in Humeral Shaft Fracture: Kwang Won Lee, Kyou Hyeun Kim, Ha Yong Kim, Young Sik Min, Hwan Jung Kim, Won Sik Choy; J Korean Soc Fract 1997;10(4):785-792. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.785

Abstract PDF: We evaluated prospectively ninety-two patients out of 130 humeral shaft fractures requiring surgical stabilization from January 1991 to December 1995. Among them, thirty-one patients received open reduction and internal fixation with plate & screws(PLT). Thirty-one patients received closed reduction & antegrade intramedullary nail fixation(IMN). Thirty patients received closed reduction & antegrade and retrograde endernail fixation(EN). Average follow-up period was 20.7 months. Eleven patients had primary radial nerve palsies. The higher incidence of nonunion was found on IMN(42%), and EN(20%), than PLT(8%). We concluded that the result of IMN was not superior to that of PLT or EN.

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Closed Interlocked intramedullary nailing of the humerus shaft Fracture: Bu Bwan Kim, Jong ln Yim, Hee Yeong Chung, Joon Young Park; J Korean Soc Fract 1996;9(1):177-184. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.177

Abstract PDF: The interlocked intramedullary nailing of humerus shaft fracture has been used as a available method because of the advantages, including relatively simple procedure, stable fixation method, and allowing early ROM and low complication. The authors have reviewed 24 cases of humerus shaft fractures, which were treated with closed interlocked intramedullary nailing from Mar. 1992 to Feb. 1994 at Dae-Dong General Hospital. The results were as follows; 1. Twenty four patients treated with intramedullary nailing revealed primary bone union and the average time for bone union was about 8.5 weeks. 2. There was no serious post operative complication such as nonunion, infection, rotatory deformity, metal failure of nail or interlocking screw. 3. According to the Stewart & Hundley classification of result, excellent, good and fair were observed in 21 cases(87%). 4. To prevent the impingement syndrome and rotator cuff injury, the proximal end of the nail was countersunk but the deeper the insertion, the more difficult the removal.

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Treatment of the humeral shaft fracture with interlocking intramedullary nail: Seok Beom Kim, Jeong Woung Lee, Won Tai Choi; J Korean Soc Fract 1996;9(1):170-176. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.170

Abstract PDF: In general, fracture of the shaft of the humerus is treated non-operative or by operative methods. The accepted treatment of the Isolated low-energy humeral shaft fracture is non-operative method. However, the fracture of the humerus that are associated with high energy, significant communition, unstable fracture patterns, or fractures that have been difficult to reduce or maintain reduction have been difficult to treat or maintain reduction have been difficult to treat by non-operative method. This has led to the use of operative intervention for the treatment of the humeral shaft fracture. The use of open technique with plate and screw is difficult due to potential injury of the neurovascular structure, increased risk of the infection and extensile exposure of the fracture site. Intramedullary nailing has advantages over other techniques of internal fixation and has been used to maintain the alignment and length of humerus. Especially, hiornechanically locked intramedullary nailing has the theoretical advantage of providing a weight shearing device and a ability to decrease the effect of rotational shear at the fracture site. This would increase the inherent stability at the fracture site and thus promote union. Authors performed interlocking intramedullary nailing for 35 cases of humeral shaft fracture from July-1993 until May-1995.

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A Treatment of Humeral Shaft Fracture with Closed Interlocking Nailing: Kun Yung Lee, Myung Sik Park, Keun Kwon Kang; J Korean Soc Fract 1995;8(1):159-166. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.159

Abstract PDF: The ideal treatment of acute fractures of the humeral shaft remains controversial. It is generally accepted that conservative treatment is best for isolated closed fractures of the humerus shaft. But recently, in case of surgical management, intramedullary nailing treatment has reported good results. Authors have analysed 20 cases of the humeral shaft fractures treated with closed intramedullary nailing at the department of orthopedic surgery, Lee-Rha general hospital from June 1991 to December 1993 with minimal 1 year follow up. The results were as follows 1. In the 20 cases, the age between 20 and 40 years old was taken place 60% and the most common cause of injury was traffic accident (75%) 2. It was worthwhile to define the relationship between union time and Winquist-Hansen classification which used in femoral shaft fracture. And the average bone union time was 8 weeks except 3 cases, especially delayed union was found in type 3 of Winquist-Hansen classification. But 2 cases were united after 9 monthes follow up without secondary procedure. 3. Problem in Seidel nailing was flilure of expansion of distal portion and in Russel-Taylor nailing was impairement of internal rotation of shoulder and delayed union due to iatrogenic distraction at the fracture level during operation. In according to the above results to treat the humeral shaft fracture, closed intramedullary inter-locking nailing was satisfactory enough to obtain bone union and early recovery of shoulder motion. Also, the Winquist-Hansen classification is useful guide to find the bone union time in the treatment of humeral shaft fracture with interlocking nail.

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Operative Treatment of the Humeral Shaft Fracture: Sang Won Park, Hak Yoon Kim, Yong Kyung Choi; J Korean Soc Fract 1994;7(2):648-653. Published online November 30, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.2.648

Abstract PDF: The role of internal fixation in the treatment of acute fractures of the humeral shaft remains controversial. It is generally accepted that conservative management is best for isolated closed fractures of the humeral shaft, but recently. the open reduction has been increased tendency. The authors analyzed radiological and clinical results of 54 cases of humeral shaft fracture treated with operation at Department of Orthopaedic Surgery, Korea University Hospital, from January 1985 to December 1992 with minimal 1 year follow up. 1. Forty cases(74%) were treated with compression plate 9 cases(74%), were treated with plate & bone graft and 5 cases(9%) were treated with lag screw. 2. Thirty two fractures healed within four months(59%) and 18 cases(33%) within 4-6 months, and average duration of union were 15.2 weeks. 3. Fifty patients(93%) recovered full range of motion of shoulder and elbow, and four patients(7%) had more than 20 degrees of limited motion. 4. The neurovascular injuries were developed in eight patients : 7 radial nerve injuries, 1 brachial plexus injury and 1 brachial artery injury. 5. There were 4 cases of complications 2 metal failure with nonunion, 1 infection and 1 transient radial nerve palsy.

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Treatment of humerus shaft fratures using hanging arm cast withplastic cast: Goang Yoon Seo, Jong Kuk Ahn, Yong Wook Kim, Jin Hyug Kim, Jeong Han Rhee; J Korean Soc Fract 1991;4(1):8-14. Published online May 31, 1991; DOI: https://doi.org/10.12671/jksf.1991.4.1.8

Abstract PDF

No abstract available.

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Periprosthetic Fracture after Proximal Humeral Intramedullary Nail, Treated by Functional Bracing - A Case Report -
Jae-Hyuk Shin, Ho-Guen Chang, Young-Woo Kim, Nam-Kyou Rhee, Yong-Bok Park, Yong-Kuk Kim
Journal of the Korean Fracture Society.2011; 24(2): 185. CrossRef

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