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Implantology of Fractures of the Shaft of Humerus

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Handbook of Orthopaedic Trauma Implantology

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Abstract

Fracture of humeral shaft (HSF) is of common occurrence. Historically from days of Hippocrates, this fracture has been treated nonoperatively. The three major advances in medicine, anaesthesia (1846), antisepsis (1865), and X-rays (1895), led to the treatment of such fractures by open reduction and internal fixation. Von Langenbeck in 1855 treated a nonunion of the humerus with screws connected by a devise designed for this purpose. In the next 100 years, a sea of change was observed in the science of osteosynthesis. Dynamic compression plates (DCP) came into use since the 1960s, and Muller introduced the interfragmentary compression of fractures. In the early part of the twenty-first century, locked plate technology was introduced which enabled surgeons to manage fractures with indirect reduction techniques while providing stable fracture fixation.

Majority of diaphyseal humeral fractures can be treated successfully by nonoperative methods like bracing, but operative intervention is indicated in several situations. There are absolute and relative indications. Open fractures takes precedence as absolute indication for operative fixation. Patients with Grade I and II open fractures may benefit from immediate internal fixation. Application of novel MIPO technique (minimally invasive plate osteosynthesis) further improved the outcome of surgical fixation having lower complication as compared to conventional open plating. In certain fractures of mid-shaft of humerus, intramedullary nailing (IMN) is preferred over plate osteosynthesis because it reduces blood loss and postoperative infections. Anterior MIPO technique is used extensively for distal diaphyseal humerus fractures. Stable fixation, preventing iatrogenic injuries to adjacent joints, and protection of the radial nerve are of utmost importance to maximize functional outcome in HSFs.

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Authors and Affiliations

  1. Jagannath Gupta Institute of Medical Sciences (JIMSH), Kolkata, West Bengal, India

    Ujjwal K. Debnath

  2. AMRI Hospital, Kolkata, West Bengal, India

    Ujjwal K. Debnath

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  1. Ujjwal K. Debnath
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Correspondence to Ujjwal K. Debnath .

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Editors and Affiliations

  1. NH Narayana Superspeciality and Multispeciality Hospitals, Howrah, West Bengal, India

    Arindam Banerjee

  2. Technical University of Munich, Munich, Germany

    Peter Biberthaler

  3. Sri Lakshmi Narayana Institute of Medical Sciences, Puducherry, India

    Saseendar Shanmugasundaram

Section Editor information

  1. Department of Orthopaedics, Apollo Gleneagles Hospitals, Kolkata, India

    Ravi Ganesh Bharadwaj

  2. Sri Dhaatri Orthopaedic, Maternity & Gynaecology Center, Vijayawada, India

    Srinivas B. S. Kambhampati

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Debnath, U.K. (2023). Implantology of Fractures of the Shaft of Humerus. In: Banerjee, A., Biberthaler, P., Shanmugasundaram, S. (eds) Handbook of Orthopaedic Trauma Implantology. Springer, Singapore. https://doi.org/10.1007/978-981-19-7540-0_68

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  • DOI: https://doi.org/10.1007/978-981-19-7540-0_68

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