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International Journal of Orthopaedics Sciences 2016; 2(2): 52-55
ISSN: 2395-1958
IJOS 2016; 2(2): 52-55
© 2016 IJOS
www.orthopaper.com
Received: 22-02-2016
Accepted: 24-03-2016
Dr. Sanjeev Chincholi
Associate Professor, Department
of Orthopedics, Gulberga
Institute of Medical Sciences,
Kalburgi, Karnataka.
Dr. Mohammed Ibrahim
Assistant Professor, Department
of Orthopedics, Gulberga
Institute of Medical Sciences,
Kalburgi, Karnataka.
Correspondence
Dr. Sanjeev Chincholi
Associate Professor, Department
of Orthopedics, Gulberga
Institute of Medical Sciences,
Kalburgi, Karnataka.
Surgical management of fracture shaft of humerus
Dr. Sanjeev Chincholi, Dr. Mohammed Ibrahim
Abstract
Fracture shaft of the humerus is a major injury commonly resulting from Road Traffic Accident. It is
associated with multiple fractures because of high velocity trauma of R T A. Although the close
reduction is ideal, the O.R. + I.F. with plating is treatment of choice in certain indications. The DCP
plating has an advantage over the ASIF type of plates in securing rigid fixation and early mobilisation
with out any external splintage. Full attention to the training and familiarity with the proposed procedure
will yield good operative results. Poor technique of fixation often results in poor results. The
complication of infection can be prevented with aseptic precautions, pre-op preparation, pre-per and post-
op antibiotics and above all meticulous dissection and minimum soft tissue damage. Early mobility of the
limb is responsible for excellent results and is good for fracture and joints and for the patient. Early
return to the jobs thus saves the patients from economic setbacks is possible by stable fixation which
result in early healing. Exploration of radial nerve in cases with radial N. palsy, for relieving compression
and neurolysis has certainly helped in early recovery. One of the aim in the management of patient with
multiple injuries is to achieve an upright position with pain free extremities. The early plating of humeral
shaft fracture help to attain this goal and prevents "Fracture disease" by allowing early mobilisation.
Keywords: Humerus, Fracture
Introduction
There is an increase in incidence of high velocity injury to lower end of humerus. These cases
with compound comminuted intercondylar fractures present a challenge to Orthopaedic
surgeons. Controversies & challenges exist regarding management of compound comminuted
intercondylar fracture distal end humerus. Dual locking anatomical or reconstruction plates
have become a gold standard for open reduction & internal fixation of closed distal humerus
fractures. But, severe contamination of bone fragments, bone loss, surrounding soft tissue
devitalization & contamination prevents usage of reconstruction plates for these compound
intra-articular fractures
[1, 2]
.
Materials and Methods
Twenty cases of fracture shaft of humerus admitted to the orthopedic department of
Government District hospital Gulbarga Between Jan 2011 to Jan 2013: cases have been taken
up for this clinical study. All were fresh fractures except one case which was malunited
fracture shaft of humerus (mid shaft, 8 weeks old.) All the cases were admitted either through
causality department or out patient block. The cases taken up are traumatic in nature and
caused mainly by Road Traffic accidents (R T A). Among these 40 cases there were only 10
females, and 30 males with ratio of 1:3. Age of the patient varied from 10 to 50 years, average
being 28.4 of these 8 were between 10 and 20 years, 12 were between 20 and 30 years, 18
were between 30 and 40 years and two cases of 50 years.
Results
The end result of all the 40 cases evaluated by regular follow up at 3 weeks, 6 weeks and 12
weeks and there after for the date of discharge, revealed that all the fractures had healed. It was
assessed after taking the following aspects in to consideration.
1. Clinical and radiological evidence of fracture union.
2. Range of movement at elbow and shoulder joint.
3. Post-operative infection.
4. Associated radial nerve palsy.
5. Time of return to duty.
6. Total period of hospitalization.