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
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
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
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.
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.
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