M.E.Müller: Atlas: Fracture 12-B3

Humerus Diaphysis,
wedge fracture,
fragmented wedge 0,09% of the total
1,35% of the humerus
6,11% of the segment

16 fractures 30,2% group 63%M, 37%F

22 fractures
41,5% group
68%M, 32%F

15 fractures
28,3% group
43%M, 57%F

Proximal section +Q Middle section +Q Distal section +Q

These are diaphyseal fractures of the humerus with a fragmented wedge third fragment but, once reduced, there is contact between the proximal and distal fragments. Ref. Manual of Internal Fixation:
232 - 251. 442 - 445 (2ª ed.).
Surgeon. RO, XG, RO.

As for the previous groups, the segmental level (subgroup) determines the treatment. The bridge plate, not interfering with the blood supply of the fragments of the wedge, is an excellent solution. If it is possible to hold on to a big fragment, it must be fixed with a lag screw. The addition of autologous cancellous bone graft is essential.

At the level of the middle third of the diaphysis it is permissible to try Hackethal´s intramedullary nailing, assuming a proportion of failures that will have to be salvaged by the standard procedure: interfragmentary compression with a lag screw and a neutralization plate of the LC-DCP type. The longer and the more fragmented the wedge, the better are the conditions for healing.

preoperative postoperative + 4 months

preoperative postoperative + 1 year

preoperative + 7 months + 1 year




						Humerus Diaphysis, wedge fracture, fragmented wedge	0,09% of the total 1,35% of the humerus 6,11% of the segment






These are diaphyseal fractures of the humerus with a fragmented wedge third fragment but, once reduced, there is contact between the proximal and distal fragments.		Ref. Manual of Internal Fixation: 232 - 251. 442 - 445 (2ª ed.). Surgeon. RO, XG, RO.

As for the previous groups, the segmental level (subgroup) determines the treatment. The bridge plate, not interfering with the blood supply of the fragments of the wedge, is an excellent solution. If it is possible to hold on to a big fragment, it must be fixed with a lag screw. The addition of autologous cancellous bone graft is essential.	At the level of the middle third of the diaphysis it is permissible to try Hackethal´s intramedullary nailing, assuming a proportion of failures that will have to be salvaged by the standard procedure: interfragmentary compression with a lag screw and a neutralization plate of the LC-DCP type. The longer and the more fragmented the wedge, the better are the conditions for healing.