II. Signs

  1. Evaluate for Radial Nerve injury
    1. Wrist Drop
    2. Finger extension weakness
    3. Supination weakness
    4. Radial Nerve decreased sensation (e.g. Two Point Discrimination)

III. Management: Manipulative reduction with local Anesthetic

  1. Pitfalls
    1. Avoid distraction of Fracture fragments
  2. Patient positioning
    1. Patient sits on stool, leaning forward
    2. Support wrist to overcome apprehension
    3. Elbow should hang free at 90 degrees flexion
  3. Reduction Technique
    1. Weight of arm alone may reduce Fracture
    2. Gentle traction downward at wrist
    3. Countertraction with a sling around axilla
    4. Assistant holds axilla sling and thumb
  4. Confirm end-to-end apposition
    1. Apply upward pressure on elbow
    2. Telescoping Humerus indicates apposition not secure

IV. Management: Splint Immobilization

  1. U-Shaped splint "Sugar-Tong"
    1. Splint medially from axilla to elbow
    2. Closed end of "U" under elbow
    3. Splint over lateral arm to Shoulder
  2. Ace wrap around splinted arm
  3. May swath by strapping Humerus to chest

V. Prognosis

  1. Heals in 8 to 10 weeks
  2. Heals well with closed reduction (non-operative)

VI. Complications

  1. Radial Nerve Injury (20% of Humeral Fractures)
    1. Travels along spiral groove, in close contact with humeral shaft

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Related Studies

Ontology: Fracture of shaft of humerus (C0272612)

Concepts Injury or Poisoning (T037)
ICD10 S42.3
SnomedCT 208289009, 157208007, 50890004
German Fraktur des Humerusschaftes
Korean 위팔뼈 몸통의 골절
English fracture of shaft of humerus, humerus shaft fracture, fracture humerus of shaft, shaft humerus fracture, fracture humerus shaft, shaft of humerus fracture, fracture of humerus shaft, fracture of humerus shaft (diagnosis), Fracture of shaft of humerus, Fracture of shaft of humerus (disorder), fracture; humerus, shaft, humerus; fracture, shaft
Spanish fractura de diáfisis de húmero (trastorno), fractura de la diáfisis del húmero, fractura de diáfisis de húmero, fractura de la diáfisis del húmero (trastorno)
Dutch fractuur; humerus, schacht, humerus; fractuur, schacht, Fractuur van schacht van humerus