The Journal of Bone and Joint Surgery, Vol 72, Issue 8 1208-1210, Copyright © 1990 by Journal of Bone and Joint Surgery, Inc
Management of fractures of the humerus in patients who have an injury of the ipsilateral brachial plexus
WW Brien, H Gellman, V Becker, DE Garland, RL Waters and DA Wiss
Department of Orthopaedics, University of Southern California School of Medicine.
Twenty-one adults who had a fracture of the middle of the humeral shaft and
an injury of the ipsilateral brachial plexus were followed for an average
of twenty-eight months. Only two of these patients showed evidence of
neurological improvement. Of the eleven patients who had an associated
traumatic injury to the brain, eight were treated non-operatively and
three, operatively. The presence of a fracture of the humerus in a flail
extremity has been found to delay rehabilitation markedly and to result in
prolonged hospitalization. Eleven fractures were treated non-operatively
with a brace or cast, and there were five non-unions, two delayed unions,
and two malunions. Of the ten fractures that were treated operatively,
three that were treated by compression-plating all united. Two fractures
were treated by external fixation; one had a delayed union and one, a
malunion. In the remaining five patients, who were treated with an
intramedullary rod, there were two non-unions, one delayed union, and one
malunion.