Humeral Fractures Associated by Forearm Fractures

Kang, Ho Jung; Han, Kae Yong; Yang, Kyu Jyun; Park, Jin Oh

Abstract

We reviewed fractured patients in Yongdong Severance Hospital for 10 years(1987-96), and collected 42 fractured patients who had concomittent ipsilateral humeral fractures and forearm fractures. The causes of injury were falling down in 21, slipping down in 2, motor vehicle accident in 15, machinery injuries in 2, crushing injury in 1 and ski injury in 1. among them 13 patients were under 15 years old. Nine cases of supracondylar fractures, three cases of lateral condylar fractures and one case of proximal humeral fractures were included. Patterns of combined forearm fractures were diverse. Twenty-three cases were occurred in the age between 16 and 59 years. Fracture patterns were very complicated in both humerus and forearm in this age. Most common humeral fracture was midshaft fracture and forearm was both forearm bone fracture. The fractures were resulted from relatively more severe traumatic event in this age than other ages. Number of patients over 60 years was six. four of them had proximal humeral fractures, one of them distal humeral fracture and one of them humeral medial comdylar fracture. Forearm fracture patterns were various but the olecranon fracture was the most common forearm fracture(4/6) in the aged. We treated fractures by many combinations of operative and conservative means. Generally K-wires were applied to the children when internal fixation was indicated. The shaft of long bones were fixated usually by dynamic compression plate and comminuted articular fractures by Egyre plate or K-wires. The average follow up period was 15 months(5-35 months). 17 complications were resulted. There were 4 nonunions, 3 elbow ankylosises, 1 Volkmann's ischemic contracture, 7 nerve paralysises(4 ulna nerve, 3 radial nerve) and 2 infections.