A 46-year-old female fell while walking and landed on her left outstretched upper extremity. Radiographs taken at a local hospital revealed a left-sided displaced mid-shaft humerus fracture with a fracture line extending to the distal humerus. She was initially treated by the outside hospital with a Sarmiento fracture brace for 6 months. She was referred to David L. Helfet, MD at the Orthopedic Trauma Service of Hospital for Special Surgery at 6 months for treatment of an unhealed fracture of the humerus. Radiographs at that time revealed a humeral non-union with significant angular (varus/recurvatum) and rotational deformities with evidence of fracture callus formation at the distal humerus fracture line. Open reduction and internal fixation (ORIF) was performed with debridement of the non-union, placement of bone graft, and placement of locking and reconstruction plates and screws in a 90/90 fashion including an interfragmentary lag screw. She returned for regular follow-up visits and healed uneventfully. At her latest follow-up visit 13 months following surgery she had excellent radiographic and clinical results including a healed humeral nonunion, resolution of pain and full range of motion of the shoulder and elbow joints and she returned to all pre-injury activities.
Anteroposterior injury radiograph (left image) revealing a mid-shaft humerus fracture with a fracture line extending to the distal humerus and radiographs at 6 months following the injury (right images) illustrating a humeral nonunion with significant deformity.
Anteroposterior and lateral radiographs 7 weeks following surgery (left images) revealing early callus formation and adequate hardware positioning and anteroposterior and lateral radiographs at 13 months (right images) illustrating a healed humerus fracture in excellent alignment.
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