FRACTURE X-RAY

MOHD ZULKHAIRI BIN MOHD ZAWAWI

BPP 2014-4764
940619-02-5579
Humerus fracture - head and neck
Humerus fracture - head and neck
• Transverse fractures of the surgical neck (red line)
• AP and lateral view of left shoulder x-ray
• Left humeral umeral head fracture
 Proximalhumerus fractures may be treated
nonoperatively with an initial period of
immobilization followed by early motion. Initial
immobilization may be achieved with a sling,
shoulder immobilizer, or a sling
 Tooptimize shoulder function, open treatment is
recommended for greater tuberosity fractures
displaced 5 mm or more
 Fixation
with heavy suture, wire, and, possibly,
screws may be considered for these fractures.
Sling
Clavicle fracture-displaced
 The distal component of this clavicle fracture is inferiorly displaced
 AP view of left shoulder x-ray
 Type III clavicle fracture
 acromioclavicular (AC) space > 1.5 cm
 coracoclavicular (CC) space increased > 50%
 In general, surgical fixation is recommended for
type II distal clavicle fractures. Treatment of these
fractures requires direct visualization and reduction
of the fracture fragments through a vertical incision.
 Stable fracture fixation can be achieved in many
ways, including through combinations of a
coracoclavicular screw, Dacron or Mersilene tape,
tension banding, a Kirschner wire (K-wire), and
clavicular plates
 The vast majority heal with nonoperative
management, which includes use of a simple
shoulder sling
 Patients with the following injuries should be sent
to a surgeon to determine if operative
intervention is necessary:
 Complete fracture displacement
 Severe displacement causing tenting of the
skin with the risk of puncture
 Fractures with 2 cm of shortening
 Neurovascular compromise
 Open fractures
Coracoclavicular Screw
Kirschner wire
Humerus fracture - Shaft
 Humerus fracture - Shaft
 Poorly defined lytic lesion of the
humerus shaft
 Oblique fracture patterns
 Fracture with varus angulation (not
visible on the lateral image)
 Left lower 1/3 humeral bone
 AP view of left upper limb x-ray
 Most closed fractures of the humeral shaft can be treated
successfully with closed methods
 Multiple closed techniques are available, including the
following :
 Traction
 Hanging arm cast
 Coaptation splint
 Velpeau dressing
 Abduction humeral/shoulder spica cast
 Functional brace
 Surgical fixation using plates and screws
 Surgical fixation with intramedullary implants
 Surgical fixation with external fixators
Hanging arm cast
Functional brace
Surgical fixation with external fixators
Coaptation splint
 REFERENCES

 http://emedicine.medscape.com/article/1239985-
treatment#d10
 http://emedicine.medscape.com/article/1261320-treatment#d9
 http://emedicine.medscape.com/article/92429-treatment#d11