Ipsilateral humeral neck and shaft fractures

Bin Zhu; Ivan Micić; Kyung-Chun Kim Kim; Jin-Young Park; Aashay Kekatpure; Predrag Stojiljković; In-Ho Jeon

doi:10.2298/VSP140902174Z

Bin Zhu Department of Hand Surgery, Ningbo No. 6 Hospital, Ningbo, Zhejiang, China
Ivan Micić Clinic for Orthopaedic Surgery and Traumatology, Faculty of Medicine, University of Niš, Niš, Serbia
Kyung-Chun Kim Kim Chungnam National University, Daejeon, Korea
Jin-Young Park Konkuk University, Seoul, Korea
Aashay Kekatpure Asan Medical Center, Ulsan University, School of Medicine, Seoul, Korea
Predrag Stojiljković Clinic for Orthopaedic Surgery and Traumatology, Faculty of Medicine, University of Niš, Niš, Serbia
In-Ho Jeon Asan Medical Center, Ulsan University, School of Medicine, Seoul, Korea

DOI: https://doi.org/10.2298/VSP140902174Z

Keywords: humeral fractures, fractures, multiple, fracture fixation, intramedullary, bone plates, treatment outcome,

Abstract

Background/Aim. Fractures of the proximal humerus or shaft are common, however, ipsilateral neck and shaft humerus fracture is a rare phenomenon. This combination injury is challenging for orthopaedic surgeons because of its complex treatment options at present. The purpose of this study was to review a series of ipsilateral humeral neck and shaft fractures to study the fracture pattern, complications and treatment outcomes of each treatment options used. Methods. A total of six patients (four female and two male) with the average age of 42.8 years (range: 36–49 years) was collected and reviewed retrospectively. Two of them were treated with double plates and four with antegrade intramedullary nail. According to the Neer’s classification, all proximal fractures were two-part surgical neck fractures. All humeral shaft fractures were located at the middle of one third. Five fractures were simple transverse (A3), one fragmented wedge fracture (B3). One patient had associated radial nerve palsy. Results. All surgical neck fractures except one united uneventfully in the average time span of 8.7 weeks. Four humeral shaft fractures healed in near anatomic alignment. The remaining two patients had the nonunion with no radiological signs of fracture healing. The average University of California, Los Angeles End-Results (UCLA) score was 23.1. On the contrary, the average American Shoulder and Elbow Surgeon's (ASES) score was 73.3. The patients treated with antegrade intramedullary nails presented 70.5 points. The ASES scores were 79 in the double plates group. Conclusions. Ipsilateral humeral shaft and neck fracture is extremely rare. Both antegrade intramedullar nailing and double plates result in healing of fractures. However the risk of complication is lower in the double plating group.

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