• Balanced and stable fixation in metaphyseal fractures and nonunion can be difficult because of osteoporosis, disuse osteopenia, comminution, joint proximity or malignant infiltration. (ox.ac.uk)
  • Surgical fixation is consequently recommended for fractures with residual displacement greater than 5 mm, or 3 mm in active patients involved in frequent overhead activity. (beemed.com)
  • Connolly et al assessed the outcome of immediate open reduction and internal fixation (ORIF) in 46 patients with open humeral diaphyseal fractures. (medscape.com)
  • Nails are the implants used in the fixation of fractures of long bones. (sharmaortho.com)
  • The Helical Blade for Humeral Nail is optimized for fixation in the humeral head. (sharmaortho.com)
  • Used for the fixation of Pertrochanteric fractures ,Intertrochanteric fractures ,High subtrochanteric fractures,Ipsilateral trochanteric fractures,Combination fractures (in the proximal femur) ,Pathological fractures. (sharmaortho.com)
  • Elegant™ Gam Nail is a new internal fixation device for the treatment of proximal femoral fractures. (sharmaortho.com)
  • It is used for the fixation of diaphysial fractures, of simple,complex or comminuted lines, up to 5 cm proximal to distal femur metaphyseal. (sharmaortho.com)
  • is system provide secure fixation of diaphysial fractures and this secure fixation permits controlled, early active rehabilitation, conductive to fall recovery. (sharmaortho.com)
  • This study analyzes risk factors associated with mechanical failure following plate fixation of humeral shaft fractures in order to further elucidate the mode and location of failure. (researchsquare.com)
  • Eleven of eighty-five humeral shaft fractures had aseptic mechanical failure requiring revision (12.9%), following initial plate fixation. (researchsquare.com)
  • Fracture characteristics (AO type, comminution, location) and fracture fixation (plate type, multiplanar, number of screws proximal and distal to the fracture) were compared between aseptic mechanical failure and those without failure. (researchsquare.com)
  • There was significant differences in fixation between the aseptic mechanical failure group and those without failure, specifically in the number of screws for proximal fixation (p=0.008) and distal fixation (p=0.040). (researchsquare.com)
  • 8 cortices of proximal fixation was a significant predictor of aseptic failure, OR 7.96 ( P = 0.011). (researchsquare.com)
  • We think this can be accounted for due to the variable bone quality, thinner cortices and multiple torsional forces in the proximal shaft that may warrant special consideration for fixation. (researchsquare.com)
  • In contrast, constructs with 4 bicortical screws or more of fixation on either side of the fracture had lower failure rates and may help to reduce the risk of mechanical failure. (researchsquare.com)
  • Common complications for open reduction internal fixation (ORIF) of humeral shaft fractures include radial nerve injury, infection, and hardware failure 3 . (researchsquare.com)
  • Ideal plate and screw fixation construct for open reduction and internal fixation of humeral shaft fractures remains controversial. (researchsquare.com)
  • Although 6-8 cortices of proximal and distal fixation have been recommended based on expert opinion 1 , there is considerable variation in plating techniques and fixation constructs to match the variability in patient and fracture characteristics. (researchsquare.com)
  • We reviewed all patients who underwent humeral shaft ORIF over a 9-year period to evaluate modes and location of failure by fracture type and fixation construct, as well as to determine the risk factors contributing to failure. (researchsquare.com)
  • The mainstay of surgical management for distal femur fractures is retrograde nailing or open reduction internal fixation (ORIF). (teachmesurgery.com)
  • In certain cases, external fixation may be used in severe comminuted or open fractures. (teachmesurgery.com)
  • The management of a peri-prosthetic distal femur fracture is more complex, and may require intramedullary nailing, open reduction internal fixation, revision to a long stem prosthesis, or a distal femoral replacement. (teachmesurgery.com)
  • In non-pathologic conditions, the greater tuberosity is never above the top of the humeral head. (beemed.com)
  • Different situations or pathological position of the greater tuberosity cause impingement and loss of strength: A) Type II cephalotubercular valgus impacted fracture and B) displaced fracture of the greater tuberosity resulting in decreased mobility and loss of strength through relaxation of the cuff. (beemed.com)
  • Pectoralis major tendons inserted 54 to 56 mm distal to the superior aspect of the humeral head and 47 mm distal to superomedial tip of greater tuberosity. (beemed.com)
  • The lateral offset of the greater tuberosity relative to the diaphyseal axis is another important anatomic variable, but sometimes difficult to restore due to the comminuted, and often porotic nature of fractured tuberosities, giving them an eggshell appearance. (beemed.com)
  • Role of the lateral offset: A) Superomedial malposition of the greater tuberosity after a subtubercular varus impacted fracture. (beemed.com)
  • Anterior dislocations with Bankart's or Hill-Sach's lesions, greater tuberosity avulsion fractures are all suitable for closed reduction. (dislocation.com.au)
  • What is the significance of a greater tuberosity fracture? (dislocation.com.au)
  • Not every greater tuberosity fracture is the same. (dislocation.com.au)
  • Distal femur fractures are fractures extending from the distal metaphyseal-diaphyseal junction of the femur to the articular surface of the femoral condyles. (teachmesurgery.com)
  • They account for around 3-6% of femur fractures . (teachmesurgery.com)
  • The classification is commonly used to classify distal femur fractures into extra-articular (type A), partial articular (type B), and complete articular (type C). (teachmesurgery.com)
  • The majority of distal femur fractures are managed surgically . (teachmesurgery.com)
  • A Hill-Sach's lesion is an impact fracture causing a depression of the postero-lateral aspect of the humeral head occurring during anterior dislocation. (dislocation.com.au)
  • Also called a McLaughlin lesion, this is a depression of the anterograde-medial aspect of the humeral head occurring during posterior dislocation. (dislocation.com.au)
  • Background: In this study, a retrospective evaluation was made of patients aged 70 years and over who were applied with proximal-femoral nail (PFN) or calcareous replacement cemented hemiarthroplasty in respect of early and late-stage morbidity and mortality and functional personal independence. (journaltocs.ac.uk)
  • The patients were separated into two groups as those applied with proximal femoral nailing and those applied with calcar replacement hemiarthroplasty. (journaltocs.ac.uk)
  • Types include proximal humeral fractures, humeral shaft fractures, and distal humeral fractures. (wikipedia.org)
  • Many humerus shaft fractures may be treated with a brace rather than surgery. (wikipedia.org)
  • Proximal and shaft fractures generally have a good outcome while outcomes with distal fractures can be less good. (wikipedia.org)
  • Displaced fractures of the humerus shaft will often cause deformity and a shortening of the length of the upper arm. (wikipedia.org)
  • A stress fracture of the proximal and shaft regions can occur after an excessive amount of throwing, such as pitching in baseball. (wikipedia.org)
  • Physical trauma to the humerus shaft tends to produce transverse fractures whereas falls tend to produce spiral fractures. (wikipedia.org)
  • Metastatic breast cancer may also cause fractures in the humerus shaft. (wikipedia.org)
  • Long spiral fractures of the shaft that are present in children may indicate physical abuse. (wikipedia.org)
  • Fractures of the humerus shaft are usually correctly identified with radiographic images taken from the AP and lateral viewpoints. (wikipedia.org)
  • Damage to the radial nerve from a shaft fracture can be identified by an inability to bend the hand backwards or by decreased sensation in the back of the hand. (wikipedia.org)
  • Could there be a shaft fracture? (dislocation.com.au)
  • Definitely image if there is any chance of a humeral shaft fracture. (dislocation.com.au)
  • If your patient has fallen directly onto the shoulder, is elderly or at some other risk of osteoporosis/pathological fracture, then I would want to exclude a humeral shaft fracture prior to any manipulation. (dislocation.com.au)
  • Fractures of the humeral shaft account for approximately 3% of all fractures. (medscape.com)
  • No classification scheme for humeral shaft fractures has gained universal acceptance, though the system developed by the Orthopaedic Trauma Association (OTA) and the Arbeitsgemeinschaft für Osteosynthesefragen (AO) is often employed (see Classification ). (medscape.com)
  • Although most fractures of the humeral shaft are inherently unstable, nonoperative treatment remains the standard. (medscape.com)
  • The humeral shaft is defined as the portion of the humerus distal to the surgical neck and proximal to the epicondyles. (medscape.com)
  • Heineman et al conducted a meta-analysis of four trials comparing treatment of humeral shaft fractures with different implants (plates and nails). (medscape.com)
  • In a retrospective study, Pretell et al reported that 17 of 19 patients with fractures of the humeral shaft treated with anterograde locked intramedullary nailing were satisfied with the results. (medscape.com)
  • Two state of the art medio-lateral (ML) locking options enable primary compression or secondary controlled dynamization and indicated for fractures in the tibial shaft as well as for metaphyseal and certain intraarticular fractures of the tibial head and the pilon tibiale. (sharmaortho.com)
  • He had a thoracic vertebral fracture (T6), left humeral shaft fracture, left femoral shaft fracture, right leg crush injury, and right comminuted femoral fracture. (e-jyms.org)
  • Operative treatment of humeral shaft fractures (AO/OTA 12) is being performed more frequently. (researchsquare.com)
  • A retrospective review of 351 humeral shaft fractures was completed at a single level I trauma center. (researchsquare.com)
  • The current dogma of humeral shaft fracture stabilization is to use a minimum of 3 screws proximal and distal to the fracture, however the current study demonstrates this is associated with higher rates of mechanical failure. (researchsquare.com)
  • This study aims to identify potential risk factors for mechanical failure following humeral shaft ORIF among patients treated at a single, high-volume, level-I trauma center. (researchsquare.com)
  • As most cases present following a fall or trauma , differentials include tibial plateau fractures , haemarthrosis , or tibial shaft fractures . (teachmesurgery.com)
  • A humerus fracture is a break of the humerus bone in the upper arm. (wikipedia.org)
  • The cause of a humerus fracture is usually physical trauma such as a fall. (wikipedia.org)
  • After a humerus fracture, pain is immediate, enduring, and exacerbated with the slightest movements. (wikipedia.org)
  • Assessment of an acute proximal humerus fracture includes a complete trauma series radiography and, where surgical treatment is considered, a CT scan with three-dimensional reconstruction. (beemed.com)
  • A Hoffa fracture is a specific type of type B articular distal femoral fracture in which there is a fracture of the posterior aspect of the femoral condyles in the coronal plane. (teachmesurgery.com)
  • Humeral Nail (Helical Blade) System permits indirect reduction of diaphyseal fractures and approximation of metaphyseal fractures. (sharmaortho.com)
  • It can also be used for diaphyseal fractures in which a retrograde approach is indicated (e.g. ipsilateral tibia and/or patella fractures, proximal or distal endoprosthesis, adipositas permagna). (sharmaortho.com)
  • The decisive elements of choice between osteosynthesis and implant are essentially the patient's age, the risk of humeral head necrosis and bone strength. (beemed.com)
  • Distal fractures may also cause deformity, and they typically limit the ability to flex the elbow. (wikipedia.org)
  • The use of interlocked 'customised' blade plates in the treatment of metaphyseal fractures in patients with poor bone stock. (ox.ac.uk)
  • This device is suitable for fracture management of the intertrochanteric, pretrochanteric, and subtrochanteric areas. (sharmaortho.com)
  • Conclusions: Proximal femoral nailing can be one of the primary treatment options for intertrochanteric hip fractures in the elderly. (journaltocs.ac.uk)
  • Partial articular fractures can be further classified into sagittal fractures of lateral condyle, sagittal fractures of medial condyle, and coronal fractures. (teachmesurgery.com)
  • Falls that produce humerus fractures among the elderly are usually accompanied by a preexisting risk factor for bone fracture, such as osteoporosis, a low bone density, or vitamin B deficiency. (wikipedia.org)
  • Proximal humerus fractures most often occur among elderly people with osteoporosis who fall on an outstretched arm. (wikipedia.org)
  • They occur both in younger patients (as the result of high energy trauma) or in older patients (from low energy trauma as a pathological fracture secondary to osteoporosis or malignancy). (teachmesurgery.com)
  • Non-operative management requires a long period of immobilisation and non-weight bearing, however is sometimes indicated for fractures with minimal displacement in a non-ambulatory or very co-morbid patient. (teachmesurgery.com)
  • The Supracondylar Nail is indicated for the stabilization of fractures of the distal femur. (sharmaortho.com)
  • The rationale behind their use subsequently led to application even in revision arthroplasty with great loss of bone stock, as well as in trauma surgery, for extremely comminuted fractures with poorly vascularized fragments, where traditional osteosynthesis cannot be applied. (openorthopaedicsjournal.com)
  • With the help of percutaneously placed towel clips fracture fragments are approximated (Fig. 5). (traumainternational.co.in)
  • If closed reduction is unsuccessful, an additional skin incision is made at fracture site for open reduction of the fragments (Fig. 5). (traumainternational.co.in)
  • Five patients with nonunion and four with comminuted or pathological acute fractures of metaphyseal areas of the tibia or humerus were treated with a 'customized' interlocked blade plate. (ox.ac.uk)
  • Humerus fractures usually occur after physical trauma, falls, excess physical stress, or pathological conditions. (wikipedia.org)
  • Middle fractures are usually caused by either physical trauma or falls. (wikipedia.org)
  • Distal humerus fractures usually occur as a result of physical trauma to the elbow region. (wikipedia.org)
  • If the elbow is bent during the trauma, then the olecranon is driven upward, producing a T- or Y-shaped fracture or displacing one of the condyles. (wikipedia.org)
  • The Arbeitsgemeinschaft für Osteosynthesefragen/Orthopedic Trauma Association (AO/OTA) classification together with the Neer classification is one of the most frequently used systems for classifying proximal humeral fractures . (radiopaedia.org)
  • This article focuses on midshaft humerus fractures. (medscape.com)
  • Conservative treatment remains the gold standard in treatment of simple undisplaced midshaft clavicle fractures, but for displaced and comminuted fractures surgical intervention is appropriate especially in young active adults. (traumainternational.co.in)
  • It can be locked into either Humeral Nail with a helical blade End Cap to create a locked, fixed-angle construct. (sharmaortho.com)
  • ELEGANT® Multi Locking Tibia Nail provide innovative locking options, in combination with cancellous bone locking screws, increase the stability of the proximal fragment for proximal third fractures. (sharmaortho.com)
  • Universal Femur nail presented as solid and cannulated nail, steel or titanium with two holes for fixed distal locking and two for proximal locking, one of them fixed and the other dynamic. (sharmaortho.com)
  • The distal beveled end of the nail aids in fracture reduction and helps in engaging in the subchondral area of the bone, thereby imparting stability. (traumainternational.co.in)
  • With oscillating movements the nail is advanced until it reaches the fracture site. (traumainternational.co.in)
  • The reduction is checked in image-intensifier and then the nail is advanced through the fracture site till it reaches distal end of clavicle. (traumainternational.co.in)
  • Although conservative treatment is the gold standard for clavicle fractures, there may be some issues like shoulder impairement, a bump at the fracture site that is cosmetically unacceptable or nonunions which happen when grossly displaced fractures are treated conservatively. (traumainternational.co.in)
  • Numerous Multiplanar locking options for expanded proximal and distal indications. (sharmaortho.com)
  • [9] In a study using the pectoralis major tendon as a reference intraoperatively reconstruction of the height of the humerus prosthesis measured by evaluating the radiological humeral length in comparison to the contralateral side within 7 mm +/- 7 mm could be shown. (beemed.com)
  • This article will focus on the general terminology of fractures and delegate discussion of particular fracture patterns to separate articles (e.g. base of skull fractures ). (radiopaedia.org)
  • Complications following a distal femur fracture include malunion (more common for fractures that have been plated), non-union (can occur in up to 19%, most common in the metaphyseal area), and secondary osteoarthritis , especially those with intraarticular extension of the fracture. (teachmesurgery.com)
  • The pectorals major insertion has a reproducible relation to the bicipital groove, making it a good landmark for tuberosities positioning in case of fracture reconstruction. (beemed.com)
  • Finding a comminuted fracture can be really useful information especially if you have the rare experience of hitting a barrier during a zero position technique - you may have an obstructing fragment. (dislocation.com.au)
  • An avulsed GT fragment (top picture) has a different mechanism (pull) to a comminuted fracture (impact) and the risk of an underlying fracture line is infinitely higher with the latter type. (dislocation.com.au)
  • This is usually seen as a subtle lucent line in the antero-inferior '3-6 o'clock' area of the glenoid with an adjacent fracture fragment. (dislocation.com.au)
  • Diaphyseal humerus fractures (AO/OTA 12) have traditionally been managed nonoperatively with splinting and functional bracing 1 . (researchsquare.com)
  • Previous biomechanical work on optimal screw configurations, plate type and the use of locking constructs have been studied as a result, but they investigate a very narrow range of fracture patterns and configurations 4 , 5 . (researchsquare.com)
  • Fractures of the skull, as with fractures of any bone, occur when biomechanical stresses exceed the bone's tolerance. (radiopaedia.org)
  • Less frequently, proximal fractures occur from motor vehicle accidents, gunshots, and violent muscle contractions from an electric shock or seizure. (wikipedia.org)
  • 2. Marongiu G, Leinardi L, Congia S, Frigau L, Mola F, Capone A. Reliability and Reproducibility of the New AO/OTA 2018 Classification System for Proximal Humeral Fractures: A Comparison of Three Different Classification Systems. (radiopaedia.org)
  • 3. Brorson S, Eckardt H, Audigé L, Rolauffs B, Bahrs C. Translation Between the Neer- and the AO/OTA-Classification for Proximal Humeral Fractures: Do We Need to Be Bilingual to Interpret the Scientific Literature? (radiopaedia.org)
  • Other risk factors for proximal fractures include having a low bone mineral density, having impaired vision and balance, and tobacco smoking. (wikipedia.org)
  • At follow-up all fractures had healed with a single complication of subacromial impingement in a patient with a proximal humeral fracture. (ox.ac.uk)
  • It usually occurs as a complication of long-bone fractures and joint reconstruction surgery. (e-jyms.org)
  • In contrast, depressed fractures will often require surgical intervention for cosmesis and reduction in the incidence of post-traumatic epilepsy 1 . (radiopaedia.org)
  • They represent 5% of all fractures in patients over 40 years of age. (beemed.com)
  • Methods: The study included a total of 77 patients aged over 70 years with an AO type 31-A1 or 31-A2 fracture. (journaltocs.ac.uk)
  • Skull fractures are common in the setting of both closed traumatic brain injury and penetrating brain injury . (radiopaedia.org)
  • The pattern of fracturing depends on the location, direction and kinetic properties of the impact as well as intrinsic features of the skull 2-4 . (radiopaedia.org)
  • Skull fractures are best imaged with CT of the brain. (radiopaedia.org)
  • Skull fractures, if closed and undisplaced, rarely need any direct management, with treatment being aimed at any associated injury (e.g. extradural hematoma). (radiopaedia.org)
  • B) Radiograph of the same patient after allograft reconstruction of the humeral head and reinsertion of the rotator cuff. (beemed.com)
  • This applies to stable or unstable types, and in traumatic and pathologic fractures. (sharmaortho.com)
  • This fracture occurs in approximately 22% of anterior dislocations and is the result of impaction of the humeral head against the antero-inferior glenoid labrum during dislocation, and is associated with rupture of the joint capsule and inferior gleno-humeral ligament damage. (dislocation.com.au)
  • It is also important to look for any evidence of an open fracture , which occurs in 5-10% of cases. (teachmesurgery.com)
  • If a severe distal fracture is suspected, then a computed tomography (CT) scan can provide greater detail of the fracture. (wikipedia.org)
  • [ 3 ] For operative candidates, the role of surgery, as well as which type of surgery is appropriate, depends on the patient and on the characteristics of the fracture. (medscape.com)
  • Results: The two groups were found to be similar in respect of age, gender, comorbidities, AO fracture type and type of anaesthesia. (journaltocs.ac.uk)
  • However, if your patient has a combination of a clear history of injury (pulling motion in or forced abduction/elevation in zero position), with a clear clinical examination (acromial step, palpable humeral head, intact AC joint, absence of bruising to upper arm) then you should be safe to attempt a technique that does not use traction, forced leveraging or torsion. (dislocation.com.au)
  • Any significant malalignment of the fracture will warrant initial realignment in A&E (with analgesia / sedation) and then immobilised using skin traction . (teachmesurgery.com)
  • [ 6 ] The proximal half is almost cylindrical, whereas distally, the anteroposterior diameter narrows into a prismatic shape. (medscape.com)