Mid-shaft Humerus Fractures (Dr. Rao)

Associated with radial nerve injury.

Treatment can be nonoperative or operative depending on location of fracture, fracture morphology, and association with other ipsilateral injuries. 

Nonoperative

• coaptation splint followed by functional brace

-Indications

*Indicated in vast majority of humeral shaft fractures

*Criteria for acceptable alignment include:  

• < 20° anterior angulation

• < 30° varus/valgus angulation

• < 3 cm shortening

• absolute contraindications

  • severe soft tissue injury or bone loss

  • vascular injury requiring repair

  • brachial plexus injury

• outcomes

  • 90% union rate

    • increased risk with proximal third oblique or spiral fracture 

  • varus angulation is common but rarely has functional or cosmetic sequelae