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Transverse Humeral Shaft Fracture



- Discussion:
    - simple transverse frxs w/out comminution may have delayed healing which requires close observation to avoid distraction & angulation;
          - this is especially true if a gap exists at frx site which cannot be closed by non operative means;

- Closed Reduction:
     - note these fractures are prone to significant varus;
     - a junior resident should attempt to produce a valgus reduction, because these frxs often tend to remain in slight varus (as is seen below);
           

- Operative Indications:
     - transverse frx which is over distracted, either as a result of initial trauma or closed treatment, will require surgery;
     - if gap exists at frx site, prolonged immobilization will not work;
     - this 30 yo non smoker had a non-union of a humeral fracture which at 3 mo., showed no signs of radiographica healing, and which at 
            surgery was found to have fat, muscle, and scar tissue w/ in the frx site;

     



Diaphyseal fractures of the humerus. Treatment with prefabricated braces.