Fractures of the humerus

Classification

 * 1) Fractures of the humeral head (AO 11 + Neer klasification type I–IV),
 * 2) fractures of the diaphysis of the humerus (AO 12) – abduction, adduction,
 * 3) fractures of the distal end of the humerus (AO 13) – supracondylar (flexion + extension), intercondylar.

Complications

 * Nerve injury:


 * nervus axillaris – fractures of the neck,


 * nervus radialis – fractures of the diaphysis,


 * nervus ulnaris – fractures of the ulnar epicondyle.


 * Injuries to blood vessels:


 * a. circumflexa humeri ant. et post. –fractures of the neck,


 * a. brachialis – fractures of the diaphysis and supracondylar fractures.



Treatment

 * Conservative (hanging cast, Desault, abduction splint, circular brace) for non-dislocated or dislocated after reposition;


 * of the surgical options are preferred:


 * neck and humeral head splint (PHILOS), spike (PHN),


 * diaphysis of the humerus - intramedullary nail secured, possibly splint,


 * distal humerus - supracondylar fractures with two crossed K-wires, intercondylar fractures with splints.