• The Journal of Korean Orthopaedic Ultrasound Society
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• v.5 no.2
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• pp.106-112
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• 2012

Radial nerve palsy after surgery of humerus fracture is uncommon complication. Occasionally it needs operative treatment because of difficulty to accurate evaluation. We report this case of radial nerve palsy after surgery of humerus shaft fracture with ultrasound examination. We checked the continuity of radial nerve and radial nerve palsy was complete recovered with conservative treatment.

• Clinics in Shoulder and Elbow
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• v.19 no.4
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• pp.223-228
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• 2016

Background: The aim of study was to confirm the clinical effectiveness and results of wide and single anterior approach for fractures occurring along length of humerus. Methods: A total of 23 patients with humeral fracture were enrolled into our study who were able to participate in at least one year of follow-up. Seven patients had segmental comminuted humeral fractures and 16 patients had distal humeral fractures. We made various tractions of the muscles to expose the proximal and the middle third humerus between the biceps and brachialis and the distal humerus by partial splitting of lateral side of biceps through a single incision. Postoperatively, we measured the Mayo elbow performance index (MEPI). Results: we achieved bone union in all 23 patients. Solid union of the bone was achieved at an average 13.9 weeks. Postoperatively, two complications were observed screw loosening and nonunion. Revision surgery was performed in both patients. The patient with bone nonunion was treated using bone grafts. No postoperative infections or peripheral neuropathies were observed. At the final follow-up (average 20 months), we found that the average MEPI functional score of the patients was 91.7 points regardless of the fracture site. Conclusions: Our whole humerus with a single incision was effective for the treatment of segmental comminuted and distal fractures. we believe it is a useful alternative to preexisting methods of fracture fixation.

• Clinics in Shoulder and Elbow
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• v.9 no.2
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• pp.169-175
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• 2006

Purpose: The purpose of this study was to evaluate the usefullness of polarus nailing in the treatment of proximal humerus fractures including 2 part, 3 part and proximal comminuted fractures. Materials and methods: Fifteen cases of proximal humerus fracture treated with Polarus nailing from March, 2002 to March, 2004 were selected. Man was 3 cases, and woman was 11 cases. There were one case of follow up loss due to decease. Average age was 60 years old (range, 23 to 84), and there were 6 cases of 2 part fracture, 3 cases of proximal segmental fracture, 5 cases of 3 part fracture. We analyzed the outcom results between 2 part fracture and 3 part fracture. The average follow up period after the operation was 1.5(range, 1 to 2) years. Range of motion (ROM), pain and functional outcome were evaluated by visual analogue scale(VAS) and american shoulder and elbow surgery (ASES) activity of daily living (ADL) functional scoring system. Results: All cases showed union on radiologic evaluation, with 2.3 months follow up. In 5 cases of 3 part fracture, average union time was 1.9 months regardless of proximal screw loosening in 4 cases. In 2 part fracture union time was 2.2 months (P>0.05). VAS pain score was 1.3, ROM was $160^{\circ}$ in forward flexion, $40^{\circ}$ in external rotation, L3 level in internal rotation, and ASES, ADL functional score was 21 in 2 part fracture. VAS pain score was 1.25, ROM was $160^{\circ}$, $43^{\circ}$ and L1 level, and ASES, ADL functional score was 21 in 3 part fracture. There were no statistically significant difference between two groups (P>0.05) VAS pain score was 1.6, ROM was $170^{\circ}$, $47^{\circ}$ and L3 level, and ASES, ADL functional score was 23 in proximal comminuted fracture. Conclusion: Polarus nailing could be used as an effective modality in certain cases of proximal humeral fracture including 2 part, proximal segmental and in cases of 3 part fractures with large greater tuberosity fragment.

• Journal of Haehwa Medicine
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• v.23 no.1
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• pp.157-166
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• 2014

Objective : The purpose of this study is to report the patient with radial nerve injury associated with humerus shaft fracture, who was improved by Korean medical treatments. Methods : The patient was treated by Jungsongouhyul pharmacopuncture, electrical stimulation therapy, physical therapy, and herbal medicine according to "Locating Yang brightness meridians" theory. Coding result, Numeric rating scale(NRS) and digital grip dynamometer were used to evaluate the wrist drop, numbness of fingers and grip power. Results : The patient showed the first sign of recovery after 6 weeks from onset. After 9 weeks from onset, the patient could perform delicate manual activity. Grip power showed noticeable improvement as well as coding result and NRS. Conclusions : The results suggest that providing Korean medical treatments according to "Locating Yang brightness meridians" theory is a good method for treating radial nerve injury associated with humerus shaft fracture. But further studies are required to concretely prove the effectiveness of this method for treating radial nerve injury associated with humerus fracture.

• Clinics in Shoulder and Elbow
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• v.1 no.2
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• pp.212-220
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• 1998

Concomitant ipsilateral fractures of the humerus, radius and ulna are uncommon combined injury and are also called "floating elbow". It was found that this injury was usually a result of rather severe trauma and frequently associated injuries to other organ systems. It is controversial in the treatment of the "floating elbow", but the current treatment recommendations are open reduction and internal fixation of both the humerus and the forearm fracture with early initiation of range of motion exercises. The authors reviewed thirteen cases of ipsilateral fractures of the humerus, radius and ulna treated in our clinic from January 1992 to March 1997, and average follow-up period was over 18 months(range, 12 to 36 months). The results obtained were as follows; 1. The most common cause of injury was traffic accident and most common location of fractures was mid-third in both humerus and forearm. 2. The shape of fractures was transverse or comminuted in most cases. 3. The good clinical results were obtained by open reduction and internal fixation of both the humerus and the forearm fracture with early initiation of range of motion exercises. 4. The recovery was affected by the severity of the initial trauma and method of the treatment. 5. According to the Lange and Foster method, the functional result was good in 8 cases, fair in 4 cases and poor in 1 cases.

• Clinics in Shoulder and Elbow
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• v.10 no.2
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• pp.204-211
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• 2007

Purpose: To evaluate the result and complication of treatment using Locking Compression Plate (LCP) for fracture of proximal humerus. Materials and Methods: Between 2004 and 2006, 21 patients with two-part and three-part fractures of the proximal humerus were treated by LCP fixation. Their average age was 54.9 years. Postoperative mean follow-up period was 22.9 months. The reduction was qualified and complication were assessed with final radiographs. The functional outcome was evaluated by Neer's rating system. Results: By Neer's functional evaluation, mean score of shoulder function was 86.3 and 18 case (86%) had excellent or satisfactory results. There was one case of nonunion but no infection or avascular necrosis of the humeral head. No correlation was found between the final result and the type of fracture, age, gender or quality of reduction. Conclusion: We obtained satisfactory result of LCP fixation for fracture of proximal humerus in this study. LCP fixation for proximal humerus fracture is a reliable method to obtain satisfactory reduction, rigid fixation and early exercise.

• Clinics in Shoulder and Elbow
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• v.20 no.4
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• pp.195-200
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• 2017

Background: This study investigated and evaluated the clinical outcomes of intra-articular lesions of traumatic anterior shoulder dislocation (TASD) associated with greater tuberosity (GT) fracture of the humerus. Methods: Subjects included 20 patients who were surgically or non-surgically treated for GT fracture of the humeurs with TASD, and followed-up for at least 2 years. The mean follow-up period was 54.1 months (range, 24-105 months). Of the 20 patients, 12 were treated surgically. Intra-articular lesions were identified randomly on magnetic resonance imaging scans (repeated thrice) by experienced radiologists and orthopedic surgeons. The accompanying intra-articular lesions were left untreated. Clinical outcomes were evaluated by Simple Shoulder Test (SST) and Western Ontario Shoulder Instability index (WOSI) at the last follow-up. Results: Intra-articular lesions were identified in 19 patients: 7 Bankart lesions, 15 humeral avulsion of the glenohumeral ligament lesions, 3 glenoid avulsion of the glenohumeral ligament lesion, and 6 inferior capsular tears. Two or more intra-articular lesions were identified in 6 patients. The mean SST score was 10.9 and the mean WOSI score was 449.3 at the last follow-up. Conclusions: For GT fracture of the humerus with TASD, a high frequency of diverse intra-articular lesions was identified. There were no incidence of recurrent shoulder dislocations, and good clinical outcomes were obtained without treatment of the intra-articular lesions. We thereby comprehend that although intra-articular lesions may occur in TASD associated with GT fracture of the humeurs, merely treating the GT fracture of the humerus is sufficient.

• Clinics in Shoulder and Elbow
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• v.9 no.2
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• pp.222-226
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• 2006

Full-thickness rotator cuff tears are relatively uncommon in the young adults. One of the pathogenesis of such tear is thought to be closely related to the specific trauma event. Favorable outcome is expected in young patient rotator cuff tears when it is diagnosed early following prompt surgical repair. However, early detection is sometimes difficult when the acute rotator cuff tear is combined with other injuries especially around the shoulder joints such as ipsilateral humerus fractures. Authors report an uncommon case of acute traumatic rotator cuff tear accompanied by the midhumerus shaft fracture in young adult.

• Archives of Reconstructive Microsurgery
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• v.19 no.1
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• pp.50-55
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• 2010

Injury of the musculocutanous nerve can be associated with a proximal humeral fracture or shoulder dislocation, and injury of the brachial plexus. However, injury of this nerve associated with a humeral shaft fracture has rarely been reported. Diagnosis of the musculocutaneous nerve injury is difficult because its sensory loss is ill-defined, and examination of elbow flexion is difficult when it is associated with fractures. We report an unusual case of musculocutaneous nerve injury in a 27 years old woman who had multiple injuries including a humerus shaft fracture, an ipsilateral radius shaft fracture, and an associated radial nerve laceration. Diagnosis of the musculocutaneous nerve injury was delayed because combined fractures of the humerus and radius prevented proper examination of the elbow motion and nerve grafting of the radial nerve delayed early elbow motion exercise. Delayed exploration of the musculocutaneous nerve 6 months after trauma showed complete rupture of the nerve at its entry into the coracobrachialis muscle and the defect was successfully managed by sural nerve graft.

• Clinics in Shoulder and Elbow
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• v.23 no.1
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• pp.20-26
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• 2020

Background: High complication rate after open reduction and internal fixation can lead to use of primary total elbow replacement (TER) in treatment of complex distal humerus fractures in elderly patients. The purpose of this study was to investigate the short-term outcomes and complications after primary TER in patients with complex distal humerus fracture. Methods: Nine patients with acute complex distal humerus fracture were treated by primary TER using the semiconstrained Coonrad-Morrey prosthesis. The mean age of patients was 72.7 years (range, 63-85 years). Clinical and radiographic outcomes were evaluated over a mean follow-up of 29.0 months (range, 12-65 months) using visual analog scale (VAS) score for pain; Mayo elbow performance score (MEPS); Quick Disabilities of the Arm, Shoulder, and Hand (Quick-DASH) score; and serial plain radiographs. Complications were also evaluated. Results: At the final follow-up, mean VAS, MEPS, and Quick-DASH scores were 1.2, 80.5, and 20, respectively. The mean range of motion was 127.7° of flexion, 13.8° of extension, 73.3° of pronation, and 74.4° of supination. There was no evidence of bushing wear or high-grade implant loosening on serial plain radiographs. Three complications (33.3%) comprising two periprosthetic fractures and one ulnar neuropathy were observed. Conclusions: Primary TER for treatment of complex distal humerus fractures in elderly patients yielded satisfactory short-term outcomes. However, surgeons should consider the high complication rate after primary TER.