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Humerus Shaft Fracture

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1. Narrow locking compression plate vs long philos plate for minimally invasive plate osteosynthesis of spiral humerus shaft fractures. Full Text available with Trip Pro

Narrow locking compression plate vs long philos plate for minimally invasive plate osteosynthesis of spiral humerus shaft fractures. Our hypothesis was that minimally invasive plate osteosynthesis (MIPO) using long philos plate (LPP) would show better clinical and radiological outcomes and less complications than narrow locking compression plate (NLCP) for spiral humerus shaft fractures with or without metaphyseal fracture extension.From January 2009 to May 2016, we retrospectively studied 35 (...) patients who underwent MIPO for spiral humerus shaft fractures with or without metaphyseal fracture extension (AO classification 12 A, B, C except A3). Eighteen patients underwent MIPO with a 4.5 mm NLCP (group I) in the early period of this study, while 17 patients underwent MIPO with LPP (group II) in the later period. Range of motion (ROM), pre- and post-operative anteroposterior (AP) and lateral angulation of the fracture, operation time, amount of bleeding, and functional outcomes including

2019 BMC Musculoskeletal Disorders

2. Use of Ayurveda and Sri Lankan traditional medicine for healing shaft of humerus fracture following nonunion Full Text available with Trip Pro

Use of Ayurveda and Sri Lankan traditional medicine for healing shaft of humerus fracture following nonunion Sri Lanka comprises of a well-established traditional orthopedic treatment system. A 14 year old child had a compound fracture over shaft of humerus. The internal fixator Kirschner (k) wire was applied following allopathic treatment and after three weeks, it was removed as there was no healing of wound over fracture site. Patient was asked to follow orthopedic clinic but defaulted (...) and in 6- months time, improved to grade 5. The difference in the QLIOF scores were analyzed using Wilcoxon signed rank test. There was a significant (p = 0.03) difference between the pre-treatment (14) and post-treatment (59) QLIOF scores. The anterior- posterior and lateral X-ray showed complete healing of the fracture. This report indicates that the methods and medicines in Ayurveda and traditional orthopedic system can successfully treat a nonunion of humerus fracture.Copyright © 2018

2018 Journal of Ayurveda and integrative medicine

3. Humerus Shaft Fracture

Humerus Shaft Fracture Humerus Shaft Fracture Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Humerus Shaft Fracture Humerus Shaft (...) Fracture Aka: Humerus Shaft Fracture From Related Chapters II. Signs Evaluate function III. Management: Manipulative reduction with local anesthetic Pitfalls Avoid distraction of fragments Patient positioning Patient sits on stool, leaning forward Support wrist to overcome apprehension should hang free at 90 degrees flexion Reduction Technique Weight of arm alone may reduce Gentle traction downward at wrist Countertraction with a sling around axilla Assistant holds axilla sling and thumb Confirm end

2018 FP Notebook

4. What should be the timing of surgical treatment of humeral shaft fractures? Full Text available with Trip Pro

weeks) in group 2 (P: .009). The mean time between bone fracture and bone union in group 1 was 113.2 days (range, 86-114 days), it was 179.2 days (range, 89-355 days) in group 2 (P < .001).Classically the first treatment option for humerus shaft fractures is conservative if there is no absolute surgical indication. Surgical treatment may be the first option if patients want to return to early everyday life. Delayed surgery means delayed physical therapy and this means delayed recovery and return (...) to everyday life. In today's technology world, it should be discussed that the initial treatment of uncomplicated humerus shaft fractures is a conservative treatment.

2020 Medicine

5. Length of stay and 30-day readmissions after isolated humeral shaft fracture open reduction and internal fixation compared to intramedullary nailing. (Abstract)

Length of stay and 30-day readmissions after isolated humeral shaft fracture open reduction and internal fixation compared to intramedullary nailing. Open reduction with internal fixation (ORIF) and intramedullary nailing (IMN) have similar union rates for treating humerus shaft fractures, but IMN leads to increased incidence of shoulder impingement and reoperation. The difference in 30-day readmission rate and length of stay (LOS) between these procedures is unknown. The objective of the study (...) was to compare 30-day unplanned readmissions and length of stay between humeral shaft fractures fixed with either ORIF or IMN.The nationwide readmissions database (NRD) was queried for patients with humeral shaft fractures treated with ORIF or IMN between 2015-2016. IMN cases were propensity matched to ORIF cases based on demographic and co-morbid variables. Multivariable logistic regression determined if treatment modality was an independent risk factor for 30-day readmission or length of stay >3 days.There

2020 Injury

6. Influence of Medial Support Screws on the Maintenance of Fracture Reduction after Locked Plating of Proximal Humerus Fractures Full Text available with Trip Pro

Influence of Medial Support Screws on the Maintenance of Fracture Reduction after Locked Plating of Proximal Humerus Fractures Technical aspects of the correct placement of medial support locking screws in the locking plate for proximal humerus fractures remain incompletely understood. This study was to evaluate the clinical relationship between the number of medial support screws and the maintenance of fracture reduction after locked plating of proximal humerus fractures.We retrospectively (...) evaluated 181 patients who had been surgically treated for proximal humeral fractures (PHFs) with a locking plate between September 2007 and June 2013. All cases were then subdivided into one of four groups as follows: 75 patients in the medial cortical support (MCS) group, 26 patients in the medial multiscrew support (MMSS) group, 29 patients in the medial single screw support (MSSS) group, and 51 patients in the no medial support (NMS) group. Clinical and radiographic evaluations included the Constant

2018 Chinese medical journal

7. Anteromedial minimally invasive plate osteosynthesis (MIPO) for distal third humeral shaft fractures - Is it possible?: A cadaveric study. (Abstract)

Anteromedial minimally invasive plate osteosynthesis (MIPO) for distal third humeral shaft fractures - Is it possible?: A cadaveric study. The purpose of this study was to evaluate the feasibility of the anteromedial minimally invasive plate osteosynthesis (MIPO) approach for distal third humeral shaft fractures and identify neurovascular structures at risk with this approach.Twenty cadaveric arms were fixed with 12-hole precontoured narrow locking compression plates (LCP) with the anteromedial (...) insertion must be done with direct exposure. Insertion of percutaneous screws in the middle part of the plate between the two incisions is not possible. This approach could be an alternative for extra-articular distal third humeral shaft fractures which provides less invasive surgical dissection, allows the use of longer distal screws, and achieves better cosmesis.Copyright © 2019 Elsevier Ltd. All rights reserved.

2019 Injury

8. Minimally Invasive Osteosynthesis with a Bridge Plate Versus a Functional Brace for Humeral Shaft Fractures: A Randomized Controlled Trial (Abstract)

Minimally Invasive Osteosynthesis with a Bridge Plate Versus a Functional Brace for Humeral Shaft Fractures: A Randomized Controlled Trial Nonoperative treatment has historically been considered the standard for fractures of the shaft of the humerus. Minimally invasive bridge-plate osteosynthesis for isolated humeral shaft fractures has been proven to be a safe technique, with good and reproducible results. This study was designed to compare clinical and radiographic outcomes between patients

2017 EvidenceUpdates

9. Complications after surgical treatment of proximal humerus fractures in the elderly-an analysis of complication patterns and risk factors for reverse shoulder arthroplasty and angular-stable plating. (Abstract)

Complications after surgical treatment of proximal humerus fractures in the elderly-an analysis of complication patterns and risk factors for reverse shoulder arthroplasty and angular-stable plating. To date, there is a lack of consensus regarding surgical treatment recommendations for complex proximal humerus fracture (PHF) patterns, especially between joint preservation and joint replacement techniques.Between 2012 and 2017, 146 patients (aged 74.1 ± 8.0 years) with complex PHF were treated (...) complication rate was 37.8% for ORIF and 22.0% for RTSA, with a revision rate of 12.1% and 5.1%, respectively, as driven primarily by persistent motion deficits. Multivariate analyses demonstrated no significant differences between the 2 procedures (P = .500). However, age was an independent protective factor against overall complications (P = .018). Risk factors for major complications in ORIF included osteoporosis, varus impaction fractures, posteromedial metaphyseal extensions <8 mm, head-shaft

2019 Journal of Shoulder and Elbow Surgery

10. Treatment of the surgical neck fracture of the humerus with a novel external fixator in the elderly with osteoporosis: biomechanical analysis. Full Text available with Trip Pro

humeral shaft specimens with osteoporosis were randomized into 2 groups. Models with the surgical neck two-part fracture of the proximal humerus were built, in which a novel external fixator (test group) and a clover plate (control group) were applied separately. In the test group, the fracture was firstly fixed with intersection pinning using 3 Schanz pins (3.5 mm), followed by the novel external fixation frame. In the control group, a clover plate and 6 cortical bone screws were applied (...) Treatment of the surgical neck fracture of the humerus with a novel external fixator in the elderly with osteoporosis: biomechanical analysis. No consensus exists on the treatment of proximal humerus fractures, especially in the elderly patients with osteoporosis. This study was aimed to evaluate the biomechanical characteristics of a novel external fixator in treating two-part surgical neck fracture of the proximal humerus in the elderly patients with osteoporosis.Sixteen female elderly

2019 BMC Musculoskeletal Disorders Controlled trial quality: uncertain

11. Failure to restore the calcar and locking screw cross-threading predicts varus collapse in proximal humerus fracture fixation. (Abstract)

Failure to restore the calcar and locking screw cross-threading predicts varus collapse in proximal humerus fracture fixation. Varus collapse is a common failure mode of proximal humerus fracture (PHF) fixation. The purpose of this study was to analyze predictors of varus collapse of PHF after open reduction, internal fixation (ORIF).All patients who underwent ORIF of a PHF from January 2008 to July 2018 were identified. Known predictors of fixation failure were assessed, including calcar (...) distance, calcar ratio, and calcar restoration. Additionally, the presence of cross-threaded screws was determined. The primary outcome analyzed was varus collapse of the fracture defined as a change in neck shaft angulation to less than 120°.There were 112 patients identified who underwent ORIF of a PHF that met inclusion criteria. The population was 75.0% female (84/112), average age was 62.5 ± 10.4 years (range 40.0-87.9), and average body mass index was 28.0 ± 5.5 (17.5-46.4). There were 17

2019 Journal of Shoulder and Elbow Surgery

12. Medial Buttress Plating for Humerus Fractures With Unstable Medial Column. (Abstract)

Medial Buttress Plating for Humerus Fractures With Unstable Medial Column. The purpose of this study was to report surgical tips and techniques on the use of additional medial buttress plate fixation in proximal humeral fractures with unstable medial column restoration after lateral locking compression plate fixation. Between April 2011 and January 2017, 17 patients with medial cortical deficiency were treated using this technique. The average follow-up period was 30 (range, 12-81) months (...) . Successful fracture healing was achieved in all 17 cases. The mean neck-shaft angle change was 1.33 degree (range, 0-7.4 degree). Anterior glenoid rim erosion occurred in 1 patient. No avascular necrosis of the humeral head or significant loss of reduction, and no implant failure or screw perforation occurred. In the first part of this study, we described in detail the indications and surgical technique applied to these fractures. In the second part, we reviewed the clinical and radiographic outcomes

2019 Journal of Orthopaedic Trauma

13. Treatment of a Complex Interprosthetic Humerus Fracture. (Abstract)

Treatment of a Complex Interprosthetic Humerus Fracture. Interprosthetic humeral shaft fractures involving shoulder and elbow arthroplasty can be difficult to manage surgically, both due to fracture and patient characteristics. Adequate fixation can be difficult, given the intramedullary nature of the adjacent implants. Careful attention must be paid to regional anatomy, and care must be taken to not damage the radial or ulnar nerve during dissection and mobilization of the fracture, especially (...) if scar tissue exists from multiple previous surgeries. Finally, fixation strategies must be used to gain stability in areas where there is a cement mantle or well-fixed intramedullary stem to impart the stability required for adequate healing and postoperative mobilization. Biologic augmentation is often used as well, given the relatively poor biologic environment for bone healing. We review our technique for operative fixation of a patient with a humeral shaft fracture between a cemented shoulder

2019 Journal of Orthopaedic Trauma

14. Surgical versus non-surgical interventions for treating humeral shaft fractures in adults. (Abstract)

Surgical versus non-surgical interventions for treating humeral shaft fractures in adults. Fractures of the shaft of the humerus account for 1% to 3% of all fractures in adults. The management of these fractures, including surgical intervention, varies widely.To assess and compare the effects of surgical versus non-surgical intervention for non-pathological fractures of the humeral shaft in adults.We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, the Cochrane (...) Central Register of Controlled Trials, MEDLINE, EMBASE, trial registers, and bibliographies of trial reports. The full search was conducted in October 2011.Considered for inclusion were all randomised and quasi-randomised (method of allocating participants to a treatment which is not strictly random; e.g. by date of birth, hospital record number or alternation) controlled trials that compared surgical with non-surgical intervention for humeral shaft fractures in adults.Two authors independently

2012 Cochrane

15. An Excellent Study of Operative Versus Nonoperative Treatment of Humeral Shaft Fractures: Commentary on an article by Fabio Teruo Matsunaga, MD, PhD, et al.: "Minimally Invasive Osteosynthesis with a Bridge Plate Versus a Functional Brace for Humeral Shaf (Abstract)

An Excellent Study of Operative Versus Nonoperative Treatment of Humeral Shaft Fractures: Commentary on an article by Fabio Teruo Matsunaga, MD, PhD, et al.: "Minimally Invasive Osteosynthesis with a Bridge Plate Versus a Functional Brace for Humeral Shaf 28375900 2018 10 30 2018 10 30 1535-1386 99 7 2017 04 05 The Journal of bone and joint surgery. American volume J Bone Joint Surg Am An Excellent Study of Operative Versus Nonoperative Treatment of Humeral Shaft Fractures: Commentary (...) on an article by Fabio Teruo Matsunaga, MD, PhD, et al.: "Minimally Invasive Osteosynthesis with a Bridge Plate Versus a Functional Brace for Humeral Shaft Fractures. A Randomized Controlled Trial". e36 10.2106/JBJS.16.01609 Ruch David S DS Duke University Medical Center, Durham, North Carolina. eng Journal Article Comment United States J Bone Joint Surg Am 0014030 0021-9355 AIM IM J Bone Joint Surg Am. 2017 Apr 5;99(7):583-592 28375891 Bone Plates Braces Fracture Fixation, Internal Fracture Healing Humans

2018 The Journal of Bone and Joint Surgery. American Volume Controlled trial quality: uncertain

16. HUmeral Shaft Fracture FIXation Study

(to either non-operative treatment or surgical fixation), participants will then be reviewed at several defined timepoints, with a combination of clinical examination, X-rays and patient-reported outcome scores. The investigators hope that study results will enable surgeons to make better-informed decisions when managing patients with humeral shaft fractures. Condition or disease Intervention/treatment Phase Closed Fracture of Shaft of Humerus Procedure: Operative Device: Humeral brace Not Applicable (...) HUmeral Shaft Fracture FIXation Study HUmeral Shaft Fracture FIXation Study - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. HUmeral Shaft Fracture FIXation Study (HU-FIX) The safety and scientific validity

2018 Clinical Trials

17. Efficacy of Physiotherapist-supervised Rehabilitation After Proximal Humerus Fracture

fracture in the same proximal humerus Other operational injuries in the same upper limb Major nerve injury (e.g. Complete radialis- or delta palsy) Open fracture Multi-trauma patient Fracture dislocation or head splitting fracture Undisplaced fracture Isolated tuberculum fracture Fracture has no precondition to ossify by conservative treatment (no bony contact between fracture parts or the humeral shaft is in contact with the articular surface) Treating surgeon considers patient unsuitable to attend (...) Efficacy of Physiotherapist-supervised Rehabilitation After Proximal Humerus Fracture Efficacy of Physiotherapist-supervised Rehabilitation After Proximal Humerus Fracture - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before

2018 Clinical Trials

18. Computer-Assisted Virtual Surgical Technology Versus Three-Dimensional Printing Technology in Preoperative Planning for Displaced Three and Four-Part Fractures of the Proximal End of the Humerus. (Abstract)

Computer-Assisted Virtual Surgical Technology Versus Three-Dimensional Printing Technology in Preoperative Planning for Displaced Three and Four-Part Fractures of the Proximal End of the Humerus. This study aimed to determine the difference between computer-assisted virtual surgical technology and 3-dimensional (3D) printing technology in preoperative planning for proximal humeral fractures.Between February 2009 and October 2015, 131 patients with 3 and 4-part proximal humeral fractures were (...) were assessed with respect to the loss of the neck-shaft angle (NSA) and loss of humeral head height (HHH).Excellent sensitivity, specificity, and accuracy for fracture characteristics were seen in all 3 groups. The correlations for NSA (p = 0.033) and HHH (p = 0.035) were higher in the virtual surgical group than in the 3D printing group. The lengths of the medial support screws in the actual choices were shorter than those in the preoperative plan for the 3D printing group, but a similar pattern

2018 The Journal of Bone and Joint Surgery. American Volume

19. Set it and Forget it: Diaphyseal Fractures of the Humerus Undergo Minimal Change in Angulation After Functional Brace Application Full Text available with Trip Pro

Set it and Forget it: Diaphyseal Fractures of the Humerus Undergo Minimal Change in Angulation After Functional Brace Application To quantify radiographic changes observed in humeral shaft frctures throughout course of treatment with functional bracing.Retrospective cohort study.Level 1 Trauma Center and affiliated Tertiary Care Center.72 retrospectively identified patients with fracture of the humeral diaphysis.Application of functional brace with radiographs obtained immediately after brace (...) angulation was 14 degrees and 4 degrees procurvatum. Fracture angulation changed a mean 2 degrees in the AP plane and 3 degrees in the sagittal plane over the course of care. Linear regression determined fracture angulation proceeds toward both varus and recurvatum at 0.01 degrees per day.Humeral shaft fractures treated non-operatively heal with minimal change in angulation after brace application. If angulation on the post-brace radiograph is acceptable and there is no history of repeat trauma

2018 The Iowa orthopaedic journal

20. Hybrid blade and locking plate fixation for proximal humerus fractures: a comparative biomechanical analysis Full Text available with Trip Pro

Hybrid blade and locking plate fixation for proximal humerus fractures: a comparative biomechanical analysis Open reduction and internal fixation of proximal humerus fractures can be difficult to achieve adequate, complication free results due to osteopenia of the proximal humerus and unstable fracture patterns. This study aimed to compare the biomechanical properties of a novel hybrid fixed angle blade plate (Fx plate) with an established fixed angle locking plate (PHILOS plate).A two-part (...) fracture was simulated in synthetic composite humeri by creating a transverse osteotomy and 10 mm fracture gap at the surgical neck. After treating the fractures with either an Fx plate or a PHILOS plate, humeral head was fixed and the shaft was displaced in a cantilever fashion. For elastic tests, loading was along the frontal and sagittal plane to achieve varus/valgus and extension/flexion, respectively. In plastic tests, loading was in a varus direction to determine the constructs' resistance

2018 Biomedical engineering online

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