5/9/2017 1 Humeral Shaft Fractures – Which Need ORIF? Melvin P. Rosenwasser, MD Robert E. Carroll Professor of Surgery of the Hand Chief , Orthopaedic Hand and Trauma Service Director, Trauma Training Center 2 Overview: Fractures of the Humeral Shaft • Anatomy • Fracture classification • Nonoperative management • Indications for Surgical Treatment • Methods of Internal Fixation – plates – rods • Special Circumstances 3 Fracture variables Open injury • Gustillo I, II, III Tscherne • soft tissue injury Periarticular injury • glenohumeral • elbow Nerve Injury • median, ulnar, radial Vascular injury • artery, vein Bone Condition • pathologic • metabolic • infectious
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5/9/2017
1
Humeral Shaft Fractures –Which Need ORIF?
Melvin P. Rosenwasser, MDRobert E. Carroll Professor of Surgery of the Hand
Chief , Orthopaedic Hand and Trauma Service
Director, Trauma Training Center
2
Overview:Fractures of the Humeral Shaft
• Anatomy
• Fracture classification
• Nonoperative management
• Indications for Surgical Treatment
• Methods of Internal Fixation
– plates
– rods
• Special Circumstances
3
Fracture variables
Open injury
• Gustillo I, II, III
Tscherne
• soft tissue injury
Periarticular injury
• glenohumeral
• elbow
Nerve Injury
• median, ulnar, radial
Vascular injury
• artery, vein
Bone Condition
• pathologic
• metabolic
• infectious
5/9/2017
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Humeral Fractures• Incidence
– 2% of all fractures
• Mechanism
– Young pts: High energy, comminution, neurovascular injury