Orthopedic Care and Consultation
Fifty six years old lady injured her arm in a motor vehicle accident and xray revealed spiral fracture of humerus.
Spiral Fracture of Lower Third HumerusThe Fracture Operated and Fixed Using Narrow DCP and Interfragmentary screw
The fracture was treated by open reduction and internal fixation using locking compression plate and interfragmentary screw. [Read more...]
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It is image that has not been taken with good quality camera but is interesting one. It is an xray of humerus in 15 year old girl that was fractured about 2 yrs back and was treated by some osteopath.
The xray showed an atrophic non union of distal third of humerus. The fracture was treated with open reduction and internal fixation using dynamic compression plate, and bone grafting
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Following xray is of 67 years old man who fell in bathroom. He presented in the out patient department three days after the injury with complaint of pain and swelling in the upper part of the arm. There was substantial bruising on the arm and swelling was noted.
The xray revealed comminuted fracture of upper end of humerus.
The patient was advised closed reduction and internal fixation using an interlock nail but patient refused for surgery.
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If after fixation of a fracture, there is failure to unite within certain amount of time, there is danger of implant getting failed.
With improved qualities of implants, meticulous surgical techniques and careful postoperative protocols, the failures can be reduced.
But still failures do occur.
After a fracture is fixed there is kind of race between fracture union and implant fatigue. Fatigue is the progressive and localized structural damage that occurs in materials when a material is subjected to cyclic loading.
In other words every time an implant is subjected to stress, there occurs a damage to it. Repetitive damage accumulates over the periods and ultimately leads to breakage of the implant.
This is one kind of fixation failure. [Read more...]
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Humerus fractures are very common fractures in young adult and elderly patients.
Fracture Humerus Showing Callus Formation
It may be noted that most of humerus shaft fractures heal well on conservative treatment.
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40 years old lady who had been operated for fracture of shaft of humerus at her native place presented in the OPD with complaint of discharge from the fracture site and pain. Patient had angulation of the arm and onexamination it should abnormal mobility.
One of the screws were visible through the wound and had backed out for most of its length.
Fracture of lower third of shaf of humerus with failed implant. The plate is off and screws have come out of the bone
Xray revealed a failed plate with backed out screws.
The patient was planned for implant removal, wound debridement and external fixation to control the infection and then followed by definitive surgery.
The patient never reported back.
Popularity: 4% [?]
The overall incidence of distal humeral fractures in adults is 0.5% of all fractures. The nature of the injury is commonly severe and is often associated with injury to surrounding soft tissue and nerves. Before we discuss the fractures, we have a look at the anatomy of distal part of humerus. [Read more...]
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Fracture of shaft of humerus is very amenable to treatment but a percentage of fractures do not heal. Normal healing of a humeral fracture occurs over 8 to 10 weeks. If the fracture has not achieved union by 3 to 4 months, it can be considered a delayed union. If union does not occur by 6 to 8 months it is called non union of the fracture.
Non unions are two types
Hypertrohic occurs due to increased vascularity which allows abundant callus to form. The callus formed has insufficient stability to prevents union. [Read more...]
Popularity: 9% [?]
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