Humerus shaft fracture (peds)
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Background
- Uncommon
- Consider abuse
- If low energy mechanism, also consider pathologic fx
- Direct trauma: transverse fx
- Violent rotation: spiral fx
- Fracture fragment may injure radial nerve
- Assess wrist extensors/supinators
- Sensation of dorsoradial hand, thumb, and second digits
Differential Diagnosis
Humerus Fracture Types
Diagnosis
- AP lateral humerus, include shoulder and elbow views
Treatment
Non-Operative
- Up to 30 degrees angulation is well tolerated
- Long arm posterior splint, sling and swathe splint, or coaptation splint
- ROM exercises in 2-3 weeks
Operative
- Open fractures
- Ipsilateral forearm injury "Floating elbow"
- Shoulder injury or poly trauma
Disposition
Non-emergent Ortho f/u
See Also
References
- Harwood Nuss
- Orthobullets