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HUMERAL SHAFT FRACTURES
Fractures of the shaft of the humerus are the result of direct
trauma or rotational injuries (Figure
18.12). The radial nerve
wraps around the posterior midshaft of the bone and is injured
in about 15 per cent of shaft fractures (Figure
18.13).
Evaluation
Suspect the diagnosis from the clinical findings of tenderness,
deformity and instability of the bone. X-rays help to confirm
diagnosis, but are most useful in judging the position and
healing of the fracture during treatment. Always check the
radial nerve function before and after fracture reduction.
Treatment
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Treat
with closed reduction and application of a coaptation
splint (Figure 18.14). Alignment need not be anatomical;
a few degrees of angulation or rotation will not
impair function. |
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Radial
nerve palsy not associated with an open fracture
will resolve in most cases. Splint the wrist in extension,
and begin passive extension exercise until motor
function returns (Figure 18.15). |
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