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2432055770245Humeral Shaft Fracture00Humeral Shaft Fracture26587457879080U slab with collar and cuff (functional brace for transverse)OT if: >20° AP angulation, >30° varus/valgus angulation, >2.5cm shortening, radial nerve palsy post-reduction, multi trauma, open, floating elbow, ipsilat forearm injury, pathological fracture, segmental00U slab with collar and cuff (functional brace for transverse)OT if: >20° AP angulation, >30° varus/valgus angulation, >2.5cm shortening, radial nerve palsy post-reduction, multi trauma, open, floating elbow, ipsilat forearm injury, pathological fracture, segmental15697207879080Management00Management15697207045960Complications00Complications26587457045960Brachial artery injury; radial nerve injury (in 20%; especially in middle and distal 1/3; usually recovers over 6-8/52 with conservative treatment; wrist drop and altered sensation 1st web space); also ulnar and median nerves; displacement (common due to many muscle attachments)00Brachial artery injury; radial nerve injury (in 20%; especially in middle and distal 1/3; usually recovers over 6-8/52 with conservative treatment; wrist drop and altered sensation 1st web space); also ulnar and median nerves; displacement (common due to many muscle attachments)26644606270625Short oblique: difficult to reduce and maintainLong spiral: tend to heal rapidly; high incidence of non-union if large gap between SegmentsTransverse: have delayed healing00Short oblique: difficult to reduce and maintainLong spiral: tend to heal rapidly; high incidence of non-union if large gap between SegmentsTransverse: have delayed healing15754356271260Classification00Classification26606505770245Peak in 30’s and 70’s; common site of pathological fracture (especially breast cancer); middle third most common00Peak in 30’s and 70’s; common site of pathological fracture (especially breast cancer); middle third most common15716255770245Epidemiology00Epidemiology2463801173480Surgical Neck Of Humerus Fracture00Surgical Neck Of Humerus Fracture48285401173481Epidemiology: more common in elderly; axillary nerve and artery most commonly injured (>50% if displaced); high incidence of AVN (especially if anatomical neck / articular surface involved); 80% are undisplaced or impactedNeer classification: Displacement = >1cm Angulation = >45°1 part: 80%; no displacement / angulation2 part: most common; displacement of 1 element3 part: displacement of 2 elements; humeral head in contact with glenoid OK4 part: displacement of 3+ elements; dislocations of glenohumeralManagement: 3 part or more / displaced need OT unless well aligned; BAS best; early mobilsation to prevent frozen shoulder If need reduction – longitudinal traction adduction push humerus laterally and prox segment medially abduct gently release traction00Epidemiology: more common in elderly; axillary nerve and artery most commonly injured (>50% if displaced); high incidence of AVN (especially if anatomical neck / articular surface involved); 80% are undisplaced or impactedNeer classification: Displacement = >1cm Angulation = >45°1 part: 80%; no displacement / angulation2 part: most common; displacement of 1 element3 part: displacement of 2 elements; humeral head in contact with glenoid OK4 part: displacement of 3+ elements; dislocations of glenohumeralManagement: 3 part or more / displaced need OT unless well aligned; BAS best; early mobilsation to prevent frozen shoulder If need reduction – longitudinal traction adduction push humerus laterally and prox segment medially abduct gently release traction1573530117411526403301076706000246380539750Humerus Fractures00Humerus Fractures 00 ................
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