Humeral Shaft Fractures: Mechanism and Evaluation

Humeral Shaft Fractures

• The most common mechanism of injury is a direct blow or a fall onto an outstretched hand.
• Typical clinical presentations include pain, swelling, and deformity in the arm, with possible numbness or tingling in the hand or fingers.
• Careful neurovascular (NV) examination is important to assess for nerve or blood vessel damage.

Classification of Distal Humerus Fractures

• No specific classification mentioned.

Treatment Principles for Humeral Shaft Fractures

• Treatment principles focus on restoring alignment, stabilizing the fracture, and allowing for early mobility.
• Recommended timing for treating closed humeral shaft fractures is within 1-2 weeks.
• Open humeral shaft fractures require urgent treatment, typically with surgical debridement and antibiotic administration.

Fracture Patterns and Types

• Fracture patterns are based on the stress applied, including transverse, oblique, and spiral fractures.
• The most common type of humeral shaft fracture is a transverse fracture.
• Approximately 80-90% of humeral shaft fractures heal with nonsurgical management.

Olecranon Process Fractures

• Common symptom is pain at the posterior elbow, especially with flexion.
• First step in treatment for a nondisplaced olecranon process fracture is immobilization in a long arm cast.
• Possible symptom of a coronoid process fracture is instability of the elbow.

Elbow Stability and Fractures

• The coronoid process is believed to be the secondary stabilizing source for the elbow during valgus stress.
• The most common elbow fracture among adults is a distal humerus fracture.

Imaging and Treatment

• Olecranon process fractures can usually be demonstrated by X-ray or CT scan.
• Displaced olecranon process fractures may require open reduction and internal fixation (ORIF) for proper alignment of the bone.
• Avulsion fracture of the coronoid process can be caused by a violent traction force on the brachialis muscle.
• Loss of motion can occur regardless of treatment after healing from an olecranon process fracture.
• Patients with radial head fractures may experience elbow pain and stiffness, with possible instability.

Learn about the mechanism of injury for humeral shaft fractures, including direct trauma from MVAs and indirect trauma from falls. Understand the different fracture patterns based on the stress applied, and explore the clinical evaluation of humeral shaft fractures.