Surgical Care at the District Hospital
Part 1 2 3 4 5 6 Primary Trauma Care Manual
Traumatology and orthopaedics
Acute Trauma Management
Trauma in perspective
Principles of Primary Trauma Care
Six phases of Primary Trauma Care
Procedures
Orthopaedic Techniques
Traction
Casts and Splints
Application of external fixation
Diagnostic imaging
Physical therapy
Crania burr holes
Orthopaedic Trauma
Upper extremity injuries
The hand
Fractures of the pelvis and hip
Injuries of the lower extremity
Spine injuries
Fractures in children
Amputations
Complications
War related trauma
General Orthopaedics
Congenital and developmental problems
Bone tumours
Infection
Degenerative conditions
Trauma in Perspective
 

> CLAVICLE FRACTURES
> ACROMIAL-CLAVICULAR JOINT SEPARATION
> SHOULDER DISLOCATION
> PROXIMAL HUMERUS FRACTURES
> HUMERAL SHAFT FRACTURES
> SUPRACONDYLAR FRACTURES OF THE HUMERUS
> OLECRANON FRACTURES
> FRACTURES OF THE RADIAL HEAD AND NECK
> ELBOW DISLOCATION
> FOREARM FRACTURES
> DISTAL RADIUS FRACTURES
> CARPAL FRACTURES AND FRACTURE DISLOCATIONS





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).

Figure 18.12
Figure 18.12


Figure 18.13
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

:: 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.
Figure 18.14
Figure 18.14

:: 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).
Figure 18.15
Figure 18.15

> CLAVICLE FRACTURES
> ACROMIAL-CLAVICULAR JOINT SEPARATION
> SHOULDER DISLOCATION
> PROXIMAL HUMERUS FRACTURES
> HUMERAL SHAFT FRACTURES
> SUPRACONDYLAR FRACTURES OF THE HUMERUS
> OLECRANON FRACTURES
> FRACTURES OF THE RADIAL HEAD AND NECK
> ELBOW DISLOCATION
> FOREARM FRACTURES
> DISTAL RADIUS FRACTURES
> CARPAL FRACTURES AND FRACTURE DISLOCATIONS



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  Kep Points  
Humeral shaft fractures result from direct trauma or rotation of the arm


Treat by closed means in a coaptation splint



 
The most significant complications are radial nerve injury and non-union.