Distal Humeral Shaft Fracture

Lee Hunter MD, MBA

Hunter Medical Founder and Chief Medical Officer

June 2018

 

Humeral diaphyseal fractures in active adults are fairly common and often require surgical treatment to ensure proper healing. Fractures involving the distal third of the humeral shaft are often approached posteriorly, as access and plate application to the anterior aspect of the distal humerus is limited.

 

35 YOM WITH COMMINUTED DISTAL DIAPHYSEAL HUMERUS FRACTURE

The patient was involved in a motor vehicle accident and sustained a comminuted distal humeral diaphyseal fracture. Neurovascular exam was normal. Given the length and comminution of the fracture, and thus the challenges maintaining alignment non-operatively, surgical treatment was elected.

The Procedure

The patient was placed in the lateral decubitus position utilizing the ElbowLOC® Arm Positioning System. A standard posterior approach was made. The radial nerve and vascular bundle were identified, mobilized, and protected. Dual acetabular reconstruction plates were utilized and extended from above the radial neurovascular bundle to engage on either humeral column distally. The patient’s post op course was uneventful and radiographic union occurred by 10 weeks.

 

The posterior approach allows excellent exposure for diaphyseal humerus fractures such as this. The lateral position requires an arm support to stabilize the upper arm for the procedure. A low profile arm support, such as the ElbowLOC® Lateral Positioner, works very well for these procedures. In my experience, sterile Mayo tables are too bulky and hinder intraoperative arm and elbow motion and access. Similarly, many commercially available lateral arm positioners are unnecessarily complicated, difficult to apply, and cumbersome to use. The ElbowLOC Lateral Positioner is completely sterile, low profile, and is easily applied and adjusted by the surgeon as needed intraoperatively.

 

This case is another great example of how the ElbowLOC® simplifies and accelerates procedural times for many elbow surgeries and makes surgery easier for the surgeon, patient, and staff!

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