M.E.Müller: Atlas: Fracture 12-C3

Humerus, Diaphysis,
complex fracture, irregular 0,05% of the total
0,71% of the humerus
3,23% of the segment

7 fractures
25% group
43%M, 57%F

14 fractures
50% group
64%M, 36%F

7 fractures
25% group
57%M, 43%F

With two or three intermediate fragments +Q With limited shattering (<4cm) +Q With extensive shattering (>=4cm) +Q

The type C corresponds to complex multifragmentary fractures, characterized by the fact that, once reduced, there is no contact between the main proximal and distal fragments.
Ref. Manual of Internal Fixation:
232 - 251. 442 - 445.
Surgeon. RO, RO.

There appears to be a general agreement about the indication of conservative treatment for the multifragmentary diaphyseal fractures of the humerus; namely, the more complex and irregular the fractures are, the more conservative treatment is indicated. There are several reasons for this. First of all, the multifragmentation spreads the loads and they do not concentrate in one spot, the displacements are of a lesser magnitude and the alignment is easier to obtain and to stabilize by conservative methods. Second, surgical treatment is more difficult and risky, both

because of the radial nerve and because of the difficulty of internally fixing several fracture fragments involving frail cortices. Limited residual displacements are well compensated for and will not severely impair function.

The conservative treatment failures usually consist of a pseudoarthrosis located at one of the fracture sites (the one under greater loads) while the remainder heal. It will then require surgical reconstruction by internal fixation, a much less difficult procedure to perform than in the fresh fracture.

preoperative + 4 months




						Humerus, Diaphysis, complex fracture, irregular	0,05% of the total 0,71% of the humerus 3,23% of the segment






The type C corresponds to complex multifragmentary fractures, characterized by the fact that, once reduced, there is no contact between the main proximal and distal fragments.		Ref. Manual of Internal Fixation: 232 - 251. 442 - 445. Surgeon. RO, RO.

There appears to be a general agreement about the indication of conservative treatment for the multifragmentary diaphyseal fractures of the humerus; namely, the more complex and irregular the fractures are, the more conservative treatment is indicated. There are several reasons for this. First of all, the multifragmentation spreads the loads and they do not concentrate in one spot, the displacements are of a lesser magnitude and the alignment is easier to obtain and to stabilize by conservative methods. Second, surgical treatment is more difficult and risky, both	because of the radial nerve and because of the difficulty of internally fixing several fracture fragments involving frail cortices. Limited residual displacements are well compensated for and will not severely impair function. The conservative treatment failures usually consist of a pseudoarthrosis located at one of the fracture sites (the one under greater loads) while the remainder heal. It will then require surgical reconstruction by internal fixation, a much less difficult procedure to perform than in the fresh fracture.