Transverse proximal humeral fracture fractures comminuted. Medical search. Frequent questions

Connolly et al assessed the outcome of immediate open reduction and internal fixation (ORIF) in 46 patients with open humeral diaphyseal fractures. (medscape.com)
Fractures stabilized with MIPO should heal in a similar manner to fractures stabilized with external skeletal fixation applied in a closed fashion, but would require less patient and fixator care in the post-operative convalescence period. (vin.com)
The aim of this project was to investigate the biomechanical performance of the recently developed anterior variable angle locking plates vs tension band wiring used for fixation of simple and complex patella fractures. (aofoundation.org)
The specimens with simple fractures were pairwise assigned for fixation with either tension band wiring through two parallel cannulated screws, or an anterior variable angle locking core plate. (aofoundation.org)
There are certainly some complications that you never considered would develop that surprise you but in general, the surgeon can improve and limit the number of problems through a better understanding of fracture biomechanics and experience with a wide variety of patients, fixation techniques and postoperative environments. (vin.com)
I have seen a few acetabular fractures treated with internal fixation and an Ehmer sling develop marked periarticular fibrosis and dramatically reduced extension with a poor long term result. (vin.com)
Due to the bone density in osteopenic bone straight nails provide a better fixation in the proximal humerus in the region of their entry point. (aofoundation.org)
A nail offers good fixation for the metaphyseal fracture if it must be disimpacted to correct significant angulation. (aofoundation.org)
These patients underwent arthroscopically assisted reduction and internal fixation of the greater tuberosity fractures. (biomedcentral.com)
There were no reported complications such as fracture displacement, nonunion, and internal fixation failure during the follow-up period. (biomedcentral.com)
Therefore, when the fracture appears displaced, reduction and internal fixation of the greater tuberosity fractures are necessary. (biomedcentral.com)
However, cannulated screw fixation of the greater tuberosity fracture is associated with increased morbidity due to comminution or migration of the fractured fragment and poor fixation. (biomedcentral.com)
In this study, we retrospectively evaluated the clinical outcome of the fixation of humeral greater tuberosity fracture using the W-shaped suture technology. (biomedcentral.com)
A total of 17 patients with humeral greater tuberosity fracture treated with arthroscopic-assisted reduction and W-shaped suture fixation at our hospital between May 2015 and February 2019 were included in this retrospective study. (biomedcentral.com)
plate fixation was performed on the right comminuted fracture. (annalsofafricansurgery.com)
The dislocations reduced spontaneously after the fracture fixation. (annalsofafricansurgery.com)
Although the concept of internal fixation dates back to the mid-1800s, Lister introduced open reduction, internal fixation (ORIF) of patella fractures in the 1860s. (medscape.com)
Early surgical fixation initially was complicated by many obstacles, such as infection, poorly conceived implants and techniques, metal allergy, and a limited understanding of the biology and mechanics of fracture healing. (medscape.com)
Fractures with less than an anatomic reduction and less rigid fixation (ie, those with large gaps and low strain via external fixator, casting, and intramedullary [IM] nailing) heal with callous formation or secondary healing with progression through several different tissue types and eventual remodeling. (medscape.com)
Anatomic reduction and absolute stabilization of a fracture by internal fixation alter the biology of fracture healing by diminishing strain (elongation force) on the healing tissue at the fracture site. (medscape.com)
Absolute stability with no fracture gap (eg, via open reduction and internal fixation using interfragmental compression and plating) presents a low strain and results in primary healing (cutting cone) without the production of callus. (medscape.com)
Treatment is either immobilization or surgical fixation depending on fracture displacement and integrity of the extensor mechanism. (orthobullets.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)
Results of non-operative and operative treatment of humeral shaft fractures. (sportnetdoc.dk)
With the recent development of arthroscopy, arthroscopic treatment of humeral greater tuberosity fracture has been widely used [ 5 ]. (biomedcentral.com)

Anatomic reduction generally required extensive exposure and manipulation of the fractured bone to facilitate anatomic reconstruction of the fracture fragments. (vin.com)
Fig 3a-b Articular displacement at the central aspect of the patella (a) and rotation (b), both measured between the proximal and distal fragments after 1000, 2000, 3000, 4000, and 5000 cycles and featuring complex fractures fixed by either anterior variable angle locked plating or tension band wiring in terms of mean and standard deviation. (aofoundation.org)
The fractures are usually transverse and complete, although some may be comminuted, with overriding of fragments. (aafp.org)
A hematoma forms at the fracture site, and a small amount of bone in the distal fracture fragments is resorbed. (msdmanuals.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)

Transverse and short oblique fractures are treated using a plate or a Seidel nail. (sportnetdoc.dk)

Immobilization by casting, bracing, or splinting a joint above and below the fracture was used for most long bone fractures - except femur fractures, for which traction was the mainstay of treatment. (medscape.com)

Risk of complications is high with open fractures (which predispose to infection) and with fractures that disrupt blood vessels, tissue perfusion, and/or nerves. (msdmanuals.com)

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)
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)
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)
Reduce the proximal humeral segment to the shaft with the nail and fix it. (aofoundation.org)
For straight nails, the correct entry point is in line with the axis of the humeral shaft. (aofoundation.org)
Femoral shaft fractures are high energy injuries to the femur that are associated with life-threatening injuries (pulmonary, cerebral) and ipsilateral femoral neck fractures. (orthobullets.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)

Screws are applied at the proximal and distal ends of the plate through the insertion incisions or if necessary, through additional stab incisions. (vin.com)
Screws are not placed in the holes located in the central portion of the plate, which is often positioned over the fracture. (vin.com)
The knees with complex fractures were pairwise treated with either tension band wiring through two parallel cannulated screws plus circumferential cerclage wiring, or an anterior variable angle locking three-hole plate. (aofoundation.org)
28 fractures were treated using plates and screws. (sportnetdoc.dk)
Sutures placed through the rotator cuff tendons and the bolts increase stability, and should be used as well as the nail and screws, particularly for more comminuted and/or osteoporotic fractures. (aofoundation.org)
The left olecranon fracture was finally fixed by tension band wiring due to its transverse nature while the right was reduced and fixed with a contoured reconstruction plate and screws because it was comminuted. (annalsofafricansurgery.com)

The greater tuberosity fracture of the humerus is one of the common proximal humerus fractures among the young and male population [ 1 ]. (biomedcentral.com)

Treatment of both simple and complex patella fractures represents a challenging clinical problem. (aofoundation.org)
Recently, anterior variable angle locking plates have been developed for treatment of both simple and comminuted patella fractures (Fig 1). (aofoundation.org)
Fig 1a-c Core (a), three-hole (b), and six-hole (c) standard Variable Angle Locking Anterior Patella Plates 2.7 designed for treatment of simple and complex patella fractures. (aofoundation.org)
Sixteen pairs of human anatomical knee specimens were used to simulate either two-part transverse simple AO/OTA 34-C1 or five-part complex AO/OTA 34-C3 patella fractures by means of osteotomies, with each fracture model being created in eight pairs. (aofoundation.org)
From a biomechanical perspective, anterior locked plating of both simple and complex patella fractures provides superior construct stability vs tension band wiring. (aofoundation.org)
Patella Fractures are traumatic knee injuries caused by direct trauma or rapid contracture of the quadriceps with a flexed knee that can lead to loss of the extensor mechanism. (orthobullets.com)

22 fractures were treated using an intramedullary Seidel nail. (sportnetdoc.dk)
Multiple flexible intramedullary wires are used for segmental fractures or for diaphyseal fractures associated with fractures of the neck of the humerus. (sportnetdoc.dk)
Comminuted fractures are realigned using an intramedullary Seidel nail or multiple flexible wires. (sportnetdoc.dk)
As far as the site of fracture is concerned, those of the proximal and middle thirds of the humerus are well treated using an intramedullary nail or multiple wires or with a plate, while plating is most often the method of choice for fractures of the distal-third. (sportnetdoc.dk)
This report describes the technique of using the screw intramedullary nail for displace clavicle fracture. (traumainternational.co.in)
clavicle fracture, intramedullary nailing. (traumainternational.co.in)

The plate is inserted through one of the insertion incisions and tunneled along the periosteal surface of the bone, spanning the fracture site. (vin.com)

The aim of this study was to examine the results of different modalities applied in the treatment of 104 fresh diaphyseal fractures of the adult humerus treated in the department between January 1994 and March 1997. (sportnetdoc.dk)

Complications in fractures of the wrist are strongly related to the location of the fracture. (aafp.org)

The first of this two-part series discusses the features and evaluation of some commonly missed fractures and dislocations of the upper limb, excluding the hand. (aafp.org)
This two-part series, divided into separate discussions of the upper limb and the lower limb, reviews key diagnostic features of some commonly missed fractures and dislocations. (aafp.org)

Distal fractures may also cause deformity, and they typically limit the ability to flex the elbow. (wikipedia.org)

In general, simple fracture configurations, with minimal displacement and located within the diaphysis in young patients can potentially be adequately splinted if they are distal to the elbow or stifle. (vin.com)
Common fractures that can be confidently treated with coaptation include: isolated diaphyseal radial or ulnar fractures (not both), one, two or three metacarpal / tarsal fractures, minimally displaced tibial crest avulsions, greenstick fractures of the tibial diaphysis and some non-articular talus and tarsal bone fractures. (vin.com)

Percutaneous plating involves the application of a bone plate without making an extensive surgical approach to expose the fracture site. (vin.com)
MIPO does not allow direct visualization of the fracture site, therefore, access to intra-operative fluoroscopy or radiography greatly facilitates the surgical procedure. (vin.com)
Non-operative treatment remains the method of choice for undisplaced or minimally-displaced fractures or comminuted fractures with multiple parallel longitudinal fracture-lines over the middle-third, while surgical treatment is considered for displaced fractures and essentially depends upon the type and level of the fracture. (sportnetdoc.dk)
Not only is CT sensitive to the detection fractures but it is also able to exquisitely characterize their extent and allow for surgical planning. (radiopaedia.org)
In contrast, depressed fractures will often require surgical intervention for cosmesis and reduction in the incidence of post-traumatic epilepsy 1 . (radiopaedia.org)
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)

The displacement of the fracture block reduces the subacromial space, which can cause the shoulder to hit as it abducts, hence affecting the shoulder joint function [ 2 ]. (biomedcentral.com)

Continued research in the area of fracture healing led to a change in the philosophies and goals of fracture osteosynthesis, focusing on minimally invasive fracture stabilization techniques. (vin.com)
Hinge plate technique for osteosynthesis of comminuted proximal humeral fractures. (swissmedical.net)
Fractures with a third fragment require plate osteosynthesis. (sportnetdoc.dk)

This article focuses on midshaft humerus fractures. (medscape.com)

This injury may be a greenstick, plastic bowing or nondisplaced complete fracture. (aafp.org)

Minimally invasive procedures carry less of a risk of bacterial infection in comparison to open reconstruction procedures due to shorter duration of surgery, less soft tissue trauma, and decreased potential for intra-operative contamination of the fracture site. (vin.com)
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)
Disruption of the endosteal and periosteal blood supply occurs with the initial trauma, and maintaining adequate blood supply to the fracture site is essential for healing. (medscape.com)
These patients, primarily (after injury) referred to the trauma centre of the University Hospital Hradec Králové, were diagnosed with an unstable pelvic ring fracture as a part of multiple injuries. (bvsalud.org)

Multiple views should be obtained in adults with a suspected fracture of the elbow. (aafp.org)
Bilateral olecranon fractures with elbow dislocation are rarer. (annalsofafricansurgery.com)

The complex fracture pattern was characterized with a medial and a lateral proximal fragment, together with an inferomedial, an inferolateral, and an inferior fragment mimicking comminution around the distal patellar pole. (aofoundation.org)
In proximal humeral fractures which consist of a fracture of the greater tuberosity the trajectory of bent nails often passes through the fracture line between the greater tuberosity and the humeral head whereas straight nails penetrate the humeral head medial to the fracture line. (aofoundation.org)
Sagittal and transverse planes images were used to determine the bone bruise location in the lateral-medial and superior-inferior directions of the MR images. (preprints.org)

In cases in which the nerves are affected, then there will be a loss of control or sensation in the arm below the fracture. (wikipedia.org)

these fractures are often called insufficiency or fragility fractures. (msdmanuals.com)

MIPO may not be suitable for simple fractures and articular fractures which require precise anatomic reduction and compression. (vin.com)

An incorrect entry site results in malreduction of the metaphyseal fracture. (aofoundation.org)

In my opinion, complications that develop following management of fractures in small animal practice can be a humbling experience and clinical experience plays a major role in reducing the frequency of complications. (vin.com)
I enjoy the ongoing challenge of fracture repair and attempt to learn from complications that develop and then to apply that knowledge to the benefit of future patients. (vin.com)
Serious complications of fractures are unusual but may threaten life or limb viability or cause permanent limb dysfunction. (msdmanuals.com)
Closed fractures that do not involve blood vessels or nerves, particularly those that are quickly reduced, are least likely to result in serious complications. (msdmanuals.com)

Although the MIPO technique can be applied to proximal limb fractures, we have found that femoral and humeral fractures are typically more challenging to reduce using indirect techniques than antebrachial and crural fractures. (vin.com)
Clinicians should consider the patient's conformation as well as the location and bone fractured and think about how effective coaptation might be in effectively achieving bone splintage as apposed to limb splintage. (vin.com)
Unilateral olecranon fractures constitute 10% of upper limb fractures (1). (annalsofafricansurgery.com)

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)
After imaging studies, the olecranon fracture was classified using Mayo classification and the patient was prepared for surgery under general anesthesia. (annalsofafricansurgery.com)

Proximal humerus fractures most often occur among elderly people with osteoporosis who fall on an outstretched arm. (wikipedia.org)
Less frequently, proximal fractures occur from motor vehicle accidents, gunshots, and violent muscle contractions from an electric shock or seizure. (wikipedia.org)
Pathologic fractures occur when mild or minimal force fractures an area of bone weakened by a disorder (eg, osteoporosis, cancer, infection, bone cyst). (msdmanuals.com)
Fractures of the skull, as with fractures of any bone, occur when biomechanical stresses exceed the bone's tolerance. (radiopaedia.org)

As with any technique, not all fractures are amenable to percutaneous plate stabilization. (vin.com)
Although MIPO is most applicable to comminuted diaphyseal or metaphyseal fractures which may not be amenable to anatomic reduction, the technique can be utilized in some simple transverse fractures. (vin.com)
Femoral and humeral fractures may be amenable to MIPO after using an intra-medullary pin, femoral distractor or traction table to achieve reduction and alignment of the fracture. (vin.com)

The fracture hematoma is not removed at surgery and may contribute to increased rate of callus formation. (vin.com)
The replacement of hematoma by this structural network adds stability to the fracture site. (medscape.com)
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)

Initially the AO/ASIF principles recommended that precise anatomic fracture reconstruction be performed prior to plating. (vin.com)

[ 9 ] All fractures united primarily in satisfactory angulation of less than 5º in coronal and sagittal planes. (medscape.com)
Nondisplaced complete fractures may be missed unless an image is obtained with 15 degrees of cephalic angulation. (aafp.org)

2. Indirect fracture reduction 3. (vin.com)
However, if the fracture block is small or the fracture is seriously crushed, these materials cannot achieve accurate reduction and strong fracture effect. (biomedcentral.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)
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)

A precise entry point of the humeral nail is crucial. (aofoundation.org)
If the entry point has been chosen correctly, insertion of the nail will help reduce the fracture. (aofoundation.org)
With oscillating movements the nail is advanced until it reaches the fracture site. (traumainternational.co.in)

These principles are based on preserving blood supply by minimizing exposure and disruption of the fracture site. (vin.com)
These fractures may be associated with coracoclavicular ligament disruption. (aafp.org)

Definitive diagnosis of humerus fractures is typically made through radiographic imaging. (wikipedia.org)

Like fractures in other bone segments, proximal humeral fractures are divided into three groups subject to the severity and complexity of the respective injury 1 . (radiopaedia.org)

Bilateral fractures with posterior radio humeral dislocation are even rarer and offer a management dilemma. (annalsofafricansurgery.com)
We report one case of traumatic bilateral olecranon fractures with posterior radio-humeral dislocation without any concomitant systemic disease. (annalsofafricansurgery.com)
A radiograph showed bilateral fractures of the olecranon with posterior radio-humeral dislocation (Figure 1). (annalsofafricansurgery.com)

This injury commonly constitutes an epiphyseal separation with a fracture through the unfused physis of the proximal clavicle, rather than a true dislocation. (aafp.org)

Fracture union occurs by indirect bone healing with formation of a bridging callus followed by bony remodeling. (vin.com)
After the initial inflammatory phase, the soft callus stage begins with an infiltration of fibrous tissue and chondroblasts surrounding the fracture site. (medscape.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)

Skeletal weakness leads to fractures. (msdmanuals.com)

Although this process has been called secondary bone union or indirect fracture repair, it is the natural and expected way fractures heal. (medscape.com)

bilateral traumatic olecranon fracture is rare. (annalsofafricansurgery.com)
Bilateral fractures of olecranon are very rare. (annalsofafricansurgery.com)
Bilateral traumatic olecranon fractures in healthy individual are quite rare. (annalsofafricansurgery.com)
Olecranon fractures are commonly unilateral with bilateral fractures being quite rare (5). (annalsofafricansurgery.com)

[ 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)
Thus, 20 patients (62.5%) underwent non-operative treatment until fracture-union. (sportnetdoc.dk)

Scapular fractures are often a result of significant force. (aafp.org)

The fracture is typically accompanied by a discoloration of the skin at the site of the fracture. (wikipedia.org)
Fracture of the clavicle in a skeletally mature patient does not typically present a diagnostic dilemma. (aafp.org)
If a fracture line is not evident initially (eg, in some nondisplaced fractures), one typically becomes evident about 1 week after the injury as this small amount of bone is resorbed. (msdmanuals.com)

Skull fractures are common in the setting of both closed traumatic brain injury and penetrating brain injury . (radiopaedia.org)

Anatomy13

Diseases37

Chemicals and Drugs1

Analytical, Diagnostic and Therapeutic Techniques and Equipment23

Phenomena and Processes6

Information Science1

Health Care7

Fixation22

Treatment of humeral3

Fragments6

Oblique1

Femur fractures1

Open fractures1

Shaft18

Humerus fracture3

Screws6

Greater tuberosity fracture1

Patella6

Intramedullary6

Spanning the fracture site1

Diaphyseal fractures1

Location of the fracture1

Dislocations2

Distal fractures1

Diaphysis2

Surgical6

Displacement1

Osteosynthesis3

Midshaft1

Greenstick1

Trauma8

Elbow2

Medial3

Below the fracture1

Fragility Fractures1

Articular fractures1

Metaphyseal fracture1

Complications4

Limb3

Classification3

Occur4

Amenable3

Hematoma3

Reconstruction1

Angulation2

Reduction4

Nail3

Disruption2

Radiographic1

Bone segments1

Posterior3

Epiphyseal1

Callus2

Patterns1

Skeletal1

Heal1

Olecranon4

Operative2

Scapular1

Typically3

Traumatic1