DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20201019

Coaptation and functional bracing of adolescent humeral shaft spiral fracture: a case report and review of literature

Thiyagarajan Thiagarajan Singaram, Giriraj Harshavardhan J.K.

Abstract


Adolescent humerus shaft fractures are uncommon. Direct injuries lead to transverse fractures and indirect injuries lead to spiral and most oblique fractures. There is fracture displacement, angulation and internal rotation of the proximal fragment. There is difficulty in maintaining reduction after closed manipulation of spiral fractures. Paediatric humeral shaft fractures are treated by elastic intramedullary nails more often nowadays. We present a case of isolated spiral fracture of the middle1/3rd and distal 1/3rd junction of the humerus shaft with displacement and angulation treated successfully with closed reduction, coaptation U slab followed by functional orthosis.


Keywords


Paediatric, Humeral shaft, Spiral fracture, Closed reduction, Functional bracing

Full Text:

PDF

References


Bae DS. Shoulder dislocation and fractures of the proximal humerus and humeral shaft, In: Waters PM, Skaggs DL, Flynn JM, eds. Rockwood and Wilkins Fractures in Children, Wolters Kluwer 9th edition, Philadelphia; 2019: 695-711.

Beaty JH. Fractures of the proximal humerus and shaft in children, Instr Course Lect. PMID 1588080. 1992;41:369-72.

Shaughnessy MAO, Parry JA, Liu H, Stans AA, Larson AN, Milbrandt TA. Management of paediatric humeral shaft fractures and associated nerve palsy. Journal of Children's Orthopaedics. 2019;13(5):508-15.

Caviglia H, Garrido CP, Palazzi FF. Pediatric Fractures of the Humerus. Clin Orthop and Related Res. 2005;432:49-56.

Skaggs DL, Frick S. Upper extremity fractures in children, In: Stuart LW, John MF, eds. Lovell and Winter’s pediatric orthopaedics, Wolters Kluwer 7th edition, Philadelphia; 2014: 1702-1708.

Canavese F, Marengo L, Cravino M, Giacometti V, Pereira B, Dimeglio A, et al. Outcome of Conservative Versus Surgical Treatment of Humeral Shaft Fracture in Children and Adolescents: Comparison Between Nonoperative Treatment (Desault's Bandage), External Fixation and Elastic Stable Intramedullary Nailing. J Pediatr Orthop. 2017;37(3):156-63.

Holm CL. Management of humeral shaft fractures. Fundamental nonoperative technics, Clin Orthop Relat Res. 1970;71:132-9.

Sarmiento A, Kinman PB, Galvin EG, Schmitt RH, Phillips JG. Functional bracing of fractures of the shaft of the humerus. J Bone Joint Surg Am. 1977;59(5):596-601.

Sharma VK, Jain AK, Gupta RK, Tyagi AK, Sethi PK. Non-operative treatment of fractures of the humeral shaft: a comparative study. J Indian Med Assoc. 1991;89(6):157-60.

Abosalim A, El-Din A, El-Mowafy H. Treatment of humeral shaft fractures by a single elastic stable intramedullary nail in children. Menoufia Med J. 2015;28(1):125-32.