A collection of xrays of fracture of humerus in adult skeleton are being presented and would be updated regularly.
Image 1 – Xray of Fracture of Upper End of Humerus
Following image depicts an xray of 5 years old woman who suffered fracture of humerus after a trivial fall.
Image 2 – Xray of Fracture of Humerus Operated With Low Contact Direct Compression Plate and Bone Graft
This is a post operative xray of arm of 43 years old female who suffered a fall on her hand which resulted in fractures of humerus. The side involved was left.
At first she was given a trial of conservative treatment in form of hanging cast but serial follow up xrays failed to show any contact.
After 3 weeks of her injury, she was treated with open reduction and internal fixation using low contact dynamic compression plate (LCDCP) and autogenous bone grafting which was harvested from her lef iliac crest.
The patient is still in follow up and is showing good bone healing.
Conservative treatment in obese persons is relatively difficult. In my experience nothing suits an obese arm as for as splintage is considered. The splint does not provide any support because it cannot snugly fit due to fat and the fracture mobility is unchecked.
I have always found it difficult to treat the obese patients by conservative means. I am more inclined to treat them with a surgical procedure as I have found them to respond better.
Image 3- Xray of Intercondylar Fracture of Humerus
Intercondylar fracture of humerus occurs when person falls on flexed hand and the elbow is axially loaded. This is xray of 43 years old lady who presented to the hospital after a fall.
Intercondylar fractures are mostly treated with operative methods. This patient toowas operated upon and fractures was fixed using two reconstruction plates.
Patient is on postoperative rehabilitation exercises.
Image 4 – Xray of Shaft of Humerus Fracture with Failed Implant
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 on examination it should abnormal mobility.
One of the screws were visible through the wound and had backed out for most of its length.
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.
Image 5 – Xray of Comminuted Fracture of Upper End of Humerus
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.
Image 6 – AP and Lateral Views of Intercondylar Fracture of Humerus
Intercondylar fracture of humerus is an intra-articular injury that almost always requires operative intervention.
The xrays are of 37 years old male who sustained injury in a fall following motor vehicle accident.
Upper one is AP (antero-posterior) view and lower one is lateral view.
This patient was managed by open reduction and internal fixation using reconstruction plates.
Image 7 – Fracture Of Upper End Of Humerus With Subluxation Of Humeral Head – Anteroposterior Xray
A 45 year old man got injured in road traffic accident. He presented with pain and swelling in the right shoulder.
The xray he carried revealed a comminuted fracture along with subluxation of the glenohumeral joint.
He was offered open reduction and internal fixation as treatment but patient refused operative intervention.
He has been put in plaster of Paris cast.
Image 8 – Xray of Non Union Of Fracture of Distal End Of Humerus
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 localperson..
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
Image 9 – Fracture Humerus Upper End – Anteroposterior Xray
Fractures of upper end or proximal humerus are common in all ages and the fracture pattren varies with age. While young adults suffer this injury with high velocity trauma, the fracture can occur with trivial trauma in old age.
This is due to osteoporosis in old age.
While the fracture upper end humerus requires surgical intervention in young adults more commonly, in older patients the fracture may be treated conservatively.
The xray in picture belongs to a 75 years old lady who suffered this injury following fall on hand in her bathroom.
The patient was put on broad arm sling and treated conservatively.
Till last follow up the fracture had started showing signs of union.
Fracture 10 – Xray of Comminuted Fracture of Shaft In Humerus With Previously Operated Surgical Neck Fracture Fixed With PHILOS
PHILOS stands for Proximal Humerus internal locking system and 29 years old young male was treated for upper end of humerus and a retrauma resulted in fracture of shaft of humerus. Following is the xray picture after the second trauma.
There is a subluxation of the same shoulder joint too.
Image 11 – Ununited Fracture upper End Humerus With Fixator In Situ
The patient with following xray came for an opinion and the xray below is after one year of injury.
The patient sustained open injury which resulted in a big lacerated wound over the arm and fracture of proximal humerus.
Unable to give prior history properly, patient indicated this fixator surgery to be second , done about 4 months before the visit to me.
The fracture was still not united and clinically, the fixator was loose. Te shoulder motion was restricted
The patient was advised removal of external fixator and application of the brace followed by a definitive fixation and bone grafting at a later stage.
Image 11 – Xray of Fracture of Upper End of Humerus
Xray of fracture of proximal humerus in 38 years old lady.
The patient was treated with U slab splint.
Image 12 – Fracture of Shaft of Humerus In Distal Part – Xray
Fracture of shaft of humerus in distal part of humerus in an adult skeleton.
Image 13 – Xray of Comminuted Fracture Of Shaft of Humerus
Fracture humerus xray in 38 year old female who got this injury in motor vehicle accident.
The fracture is comminuted. THe xray shows the third butterfly fragment quite well.
Image 14 – Xray of Fracture of Distal Humerus
Xray of 54 years old lady with injury to elbow following a fall, The xray shows intercondylar fracture of distal humerus.
The patient’s arm was splinted in posterior slab and open reduction and internal fixation was suggested. Patient refused for surgical treatment.
Image 14 – Xray of Humerus Showing Failed Implant and Non Union of Humerus Fracture
Xray of 37 years old male with operated fracture humerus with DCP. The xray was taken after a year of surgery.
The xray shows pulled out screws resulting in implant failure. The fracture has not united.
Image 15 – Xray of Segmental Fracture of Humerus
This is .an xray of a highly comminuted segmental fracture of humerus which, by look of it seems to be a high energy injury. There is no info available with the file. So just sharing the image.
Shadow of plaster slab is also visible in this xray.
Image 16 – Refracture Humerus in 18 Year Old Male
Following xray is of refracture in already united, conservatively treated fracture humerus in an eighteen years old male.
This time the fracture was treated by open reduction and internal fixation using dynamic compression plate.
Image 17 – Fracture Humerus Fixed Plates and Screws With Radiological Signs of Implant Loosening
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.
Due to non biological stresses and forces the implant itself may loosen where it is fixed to the bone. Earliest sign of loosening is the radiolucent line that appears around the implant.
Loosening may lead to failure of the fixation.
If bone has not united till the time of failure, non union may result.
Following xrays are of 38 years old female who had been operated for fracture shaft of humerus about 6 months back.
She complained of pain in the arm for past two months. AP and lateral view of arm were done and revealed following.
Anteroposterior view above shows radiolucent area around the screws [marked with arrow on one screw] and there appears a lack of union.
The lateral view revealed an area of radiolucency (black line) almost all around the plate signifying that the plate itself was also loose.
The non union is very evident on lateral view.
The patient treated with bone grafting and intelock nailing of the humerus.
Xray of United Fracture of shaft of Humerus In 9 Years Old Child
Following xray is taken after 4 weeks of injury and plaster application for fracture of shaft humerus in a nine years old girl child who got injured in a motor vehicle accident.
- United Fracture Humerus In A Child
The bone has united well and alignment is right though fragments are not in anatomical position. But there is no angular deformity and child has substantial remodeling potential.
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