External fixation of the fracture of the humerus: a review of 164 cases.
During our experience with external fixation for the fractures of the shaft of the humerus since 1967, the indications have been extended to include complex metaphyseal and epiphyseal fractures of both the proximal and the distal part of the bone. We propose elastic fixation of the fragments using half frame Hoffmann external fixation. Because of anatomical considerations, the two proximal pins must be inserted laterally in the upper third of the humerus, and the two distal pins in the posterior aspect of the lower third above the olecranon fossa. If the mechanical properties of the bone are poor (due to osteoporosis) more than two pins must be used in each fragment. The advantages of the technique include fast and easy application requiring simple materials; versatility of use for fractures at different levels; possible closed reduction, as in conservative treatments; early rehabilitation of joint function; fast periosteal callus formation; and retrieval of the fixator on an outpatient basis.The reduction and the immobilization of the fracture by osteotaxis are done in emergency. Closed reduction is performed as in conservative treatments. In cases of important muscular interposition, open reduction is possible. Associated internal fixation was required in 18.4% (unstable or articular fractures). A secondary transient radial palsy is observed in 5% of the patients. Intolerance to the external fixation appears in 5.6% of cases, usually consisting of drain age and redness around the pin tracts. A general evaluation of the results gives 73.8% very good results and 93.6% satisfactory results after rehabilitation.
M
M
Hinsenkamp
F
F
Burny
Y
Y
Andrianne
J
J
Quintin
C
C
Rasquin
M
M
Donkerwolcke
A A
AA
Picchio
G
G
Asche