Online ISSN: 2515-8260

Keywords : Humerus



European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 5, Pages 1-8

Intercondylar fracture of distal humerus is one of the difficult fracture involving the humerus in adults.
Intercondylar fracture distal humerus in adults are difficult to manage due to complex anatomy of
elbow. We present a method of surgical treatment of intercondylar humerus fracture in adults by
open reduction with JESS fixator and to evaluate functional outcome and associated complication with
application of JESS fixator. MATERIALS & METHODS: It is Institutional based, prospective study carried
out from June 2021 to May 2022.Twenty cases of intercondylar distal humerus fracture were reduced
and fixed with K-wire and finally JESS was applied. Patient were follow up at 1week, 4weeks, 6weeks
& 12weeks and clinically evaluated with Mayo’s elbow performance score. RESULTS:According to AO
classification 4 cases had C1 fractures, 14 cases had C2 fractures and and 2 cases had C3 fractures. 3
cases had open injury among which two were of C2 and 1 were C3 type. All cases were operated using
paratricipital approach and average duration of JESS application was 7 week and mean follow up
duration was 9 months. Irrespective of injury pattern 9(45%) cases showed excellent results, 7(35%)
showed good results, 3(15%) cases showed fair results and 1(5%) case showed poor
results.DISCUSSION: The goal of intercondylar fracture management by JESS technique is to achieve
early range of motion of anatomically align joint. CONCLUSION:This study shows comparatively good
results using JESS fixator. This procedure is viable alternative option to ORIF dur to its simplicit, costeffectiveness
and easy implant removal on day care basis.

To study the functional outcome of proximal humerus fractures treated with locking plates

Dr. Varun Chatrabhuj Shelke, Dr. Nitin Machhindra Ghule, Dr. Anuja Patil, Dr. Swapnil Vasudeo Sonar

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 1, Pages 5451-5457

Fractures of proximal humerus account for about 4 - 5 % of all the fractures. There frequency increases in relation to the presence of Osteoporosis. In undisplaced and stable fracture pattern, conservative treatment yields a fairly good result. In this retrospective study, we will focus on the early results and the functional outcomes of the Locking plates for the proximal humeral fractures, with specific respect to fracture and soft tissue healing, radiological union, immobilisation period, infection rates and other complications encountered. Materials and Methods:Patients admitted under Orthopedic department those who suffered proximal humerus fractures in whom operative line of management was considered, in the form of plate osteosynthesis with locking plates. These were assessed for functional outcome using the UCLA (University of California and Los Angeles) score, VAS score and radiological union. Results:Functional outcome seems to be better in 2 part and 3 part fractures compared to 4 part and fracture dislocation and better in younger age group compared to older.60.86% had excellent-good results while 8.69% had fair and 30.43% had poor results. Fair or poor results were mostly seen in 4-part fractures and fracture-dislocation. Conclusions:Open reduction and Internal fixation of proximal humerus fractures with Locked Compression Plates gives good early functional results with union in all fractures.

Comparison Of Orif With Ccs And K Wire For Lateral Condyle Fractures In Children

Dr. Nikhil Gupta, Dr. Sunil Kumar Sharma, Dr. Abdul Basit, Dr. Sanjeev Gupta, Dr. Rashid Anjum, Dr. Dinesh Kumar Chadgal, Dr. Aakash Deep .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 1, Pages 2569-2574

Aim: The study's objective was to evaluate the effectiveness of Kirschner wires (K-wire) and cannulated cancellous screws (CC) for internal fixation of paediatric patients with displaced lateral humeral condyle fractures.
Materials and Methods: The study comprised 46 individuals with a displaced lateral condyle fracture of the humerus. Open reduction and internal fixation were used to treat the patients using two K-wires or 4mm CC screw. Clinical outcomes were assessed using Hardacre et al. criteria, and fractures were categorised using Milch classification.
Results: Each group contained 23 patients, with a mean age of 6.57 years (range 2 to 12 years). Compared to Milch type I (n=12), Milch type II was more prevalent (n=34). The average time for fracture union was 4.13 weeks for the CC screw group and 4.61 weeks for the K-wire group. P value equals 0.026. K-wires and CC screws were typically removed at 4.57 weeks and 13.57 weeks, respectively. The average follow-up for the K-wire group was 12.52 months, compared to 13.83 months for the CC screw. In the K-wire group, three patients (6.5%) had superficial pin site infection, two patients (4.3%) had lateral condyle prominence, and only one patient (2.2%) had lateral condyle prominence in the CC screw group.
Conclusion: For displaced lateral condyle fractures of the humerus, open reduction and internal fixation with K-wires or cannulated cancellous screws are both effective treatment options. However, screw fixation offers absolute stability at the fracture site, improving fracture healing, lowering the risk of lateral prominence, and enabling early range of motion and activity in the affected elbow.

Assessment of nutrient foramen of the humerus in the North Indian subjects

Dr. Sujata Netam, Dr. Amrita Bharti

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 1, Pages 2988-2993

The largest and longest bone in the upper limb is the humerus. The nutrient foramen is an aperture in the bone's shaft that permits blood vessels to get to the bone's medullary cavity for nutrient and growth. The long bones' nutrient foramina have been the subject of numerous published research. Since the literature has not yet established a palpable landmark for the nutrient foramina, the purpose of this study was to characterize the nutrient foramen in dry adult humeri in terms of their numbers and location.
Methods: The study comprised all the humerii (not necessarily paired and those of unknown age and sex) from the university of the Aam Admi Party's medical colleges. The length of the humerus, the number of nutrient foramen, the size of the nutrient foramen, the location of the nutrient foramen in regard to the surfaces and the zones, and the distance of the nutrient foramen from the midpoint of the humerus were all observed. All the data were recorded, and the percentage, mean, range, and standard deviation were computed as part of the statistical analysis.
Results: In our study we examined 147 humeri. Among 147 examined humeri there were 82 right humerus and 65 left humeri. The number of single nutrient foramen was most commonly recorded among examined humerus (78.91%). The examination of humerus for location of nutrient foramen based on surface showed that more than four fifth of nutrient foramen were located on anteromedial surface (83.67%). The mean total length of humerus examined was 269.75±22.53 mm and the mean distance from of nutrient foramen from proximal end of humerus was 151.93±17.57 and calculated foraminal Index (FI) was 55.36%.
Conclusion: When performing various surgical procedures on the humerus, such as treating fractures, bone repair, bone grafting, micro-surgical bone transplantation, in numerous fractures, and during extensive periosteal stripping, orthopaedic surgeons must have a thorough understanding of the anatomy of the number, location, and direction of the nutrient foramina of the humerus in order to minimise damage to the nutrient artery of the humerus.

Morphometric Analysis of Bicipital Groove of Humerus: A Cross-Sectional Study in Gujarat Region

Mehul Tandel, Daxa Kanjiya, Rahul Parmar, Tushar Nayak .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 1281-1288

Introduction: The Bicipital Groove (BG) lies below the anatomical neck of humerus, separating the greater and lesser tubercles. It lodges the tendon of Long Head of Biceps Brachii (LHBB) and ascending branch of the anterior circumflex humeral artery. The shoulder pain is frequently caused by biceps tendon pathologies, which are associated with variations in morphometry of the BG. Therefore, this study was conducted to determine morphometric features of BG in Gujarat region of India to provide additional information.
Materials & Methods: The data was collected from 100 dry adult humeral bones of unknown sex (50 right and 50 left) available in anatomy department of Pramukhswami Medical College, Karamsad, Gujarat, India. The digital Vernier caliper was used to precisely measure the BG’s length, breadth, depth, medial wall length, and lateral wall length.  The opening angle (OA) and medial wall angles (MWA) was measured by screen protractor software after capturing and transferring images of bones to the computer. Statistical analysis was done on the collected data.
Result: The length, width and depth of BG were 73.21 ± 9.08 mm, 10.15 ± 1.01 mm and 4.24 ± 0.69 mm on right side and 71.94 ± 8.45 mm, 10.11 ± 0.89 mm, 4.31 ± 0.83 mm on left sides respectively. The average opening angle on the right side was 76.11±13.79º, while on the left side was 76.11 ± 13.79º. The medial wall angle was 55.74 ± 11.92º on right side and 54.03 ± 8.94º on left side.
Conclusion: This study provides additional information on the morphometry of the BG in the Gujarat region, which can be useful for anatomists, anthropologists, orthopaedic surgeons and radiologists. The results of this study may also be used to determine prosthetic design, size, and position in humeral head replacement.

Crossed pinning versus lateral pinning for displaced extension type supracondylar fractures of the humerus in children

Dr. Jasani Ajay Batuk, Dr. Jayur Solanki, Dr. Parimal Patel

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 1448-1453

highest incidence of supracondylar fracture of humerus is in Pediatric age group and the most common being the extension type of supracondylar fracture. Precise diagnosis evaluation and planning is required for deciding the best modality of treatment for these fractures. They are most widely managed by utilizing two methods; lateral pinning and crossed pinning. So aim of study remains to determine the superiority of either of these techniques over the other.
Materials and Methods: A prospective, single blinded, randomized control trial with 53 cases, out of which 39 were boys and 14 were girls was conducted. Mean age group of study was 6.9 years. Acoording to Gartland classification Type III supracondylar fractures were included in this study. Detailed post-operative primary assessment for major loss of reduction and iatrogenic ulnar nerve injury was done. Clinical outcome, elbow range of motion, radiographic measurement, Flynn’s grading and complications were the secondary parameters which were assessed.
Results: Both groups exhibited no major loss of reduction. Change of Boumann angle was statistically insignificant. Metaphysial-Diaphysial angle, Flynn grade, carrying angle and total elbow range of motion between the two groups showed no statistically significant difference.
Conclusion: Lateral pin fixation offers parallel results in terms of functional and radiological outcomes and nearly equal mechanical stability compared to medial-lateral pinning without the added shortcoming of possibility of iatrogenic ulnar nerve injury.

To Compare Functional Outcome of Close and Open Cross Pinning in Treatment of Gartland Type 3 Supracondylar Humerus Fracture in Children

Dr. Arpit Tiwari Dr. Sunil Barod Dr. Puneet Maheshwari Dr. Ankit Verma Dr. Ashok Nagla

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 9582-9586

The aim of this studyto compare functional outcome of close and open cross pinning in treatment of Gartland  type 3 supracondylar humerus fracture in children. All patients operated with mediolateral cross pinning were included in this study. The age range was 3-12 years at the time of surgery. All patients were followed till the fracture united radiologically. The diagnosis was based on conventional X-ray imaging

To study using Flynn’s criteria outcome in displaced supracondylar fracture humerus post operatively

Dr. Mohd. Sameer Qureshi Dr. Mohd. Shoaib Qureshi Dr. Ankit Verma Dr. Romin Memon

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 5, Pages 675-679

The aim of this study is to study outcome in posteromedial and posterolateral displaced supracondylar fracture humerus post operatively. All procedures and protocols used in this study had been approved by the medical ethics committee of our institution. Children with fractures are usually first seen in the casualty unit. The orthopaedic doctor on call will examine the child, assess the vascular and neurological status, and review the radiographs of the elbow. Evaluation of the neurology and vascular status was repeated in the ward. After obtaining the informed consent for the study and surgery, the patients would be kept fasted for surgery.
Result: There were only 10 patients in whom the result was rated as fair: 08 had posteromedial displacement and 02 had posterolateral displacement. 02 patients rated as poor, had posteromedial displacement.
Conclusion: From this prospective study, we concluded that high rates of neurovascular complications in supracondylar humerus fracture in children demand High index of suspicion in this fracture especially in POSTEROMEDIALLY displaced fractures. Posteromedialy displaced supracondylar fracture humerus should be considered as a red flag sign for neurovascular complications. Also better functional outcome is associated with cross k-wire fixation in Posterolateral displaced fracture.

A Comparative study between Percutaneous cross vs Lateral K wire fixation in displaced supracondylar humerus fractures .

Paramesha K C , Nitin N Sunku, Raghavendra J

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 695-700

Background: Supracondylar humerus fractures are one of the commonest fractures in the paediatric age group. Displaced fractures of these kind, that is, Gartland type III are treated by closed or open reduction and k wire fixation. Cross k wire and lateral wires are the commonest configurations used for fixation. The present study aims to evaluate the difference between the two configurations in terms of surgical technique, functional outcome and complications. Objectives: To compare the functional and radiological outcome of lateral and cross pinning of displaced supracondylar humerus fractures of children METHODOLOGY:This was a prospective comparative study of 40 paediatric patients with supracondylar fracture humerus in the department of Orthopaedics in a Tertiary care Centre after the inclusion & exclusion criteria were met. Immediately after admission , a detailed neurovascular examination was done. Anteroposterior & Lateral Radiographs of the elbow were taken & type of fracture was noted. Informed and written consent was taken from the parent/guardian. Then 20 patients were treated with Lateral K- wire technique  (Group A ) and another 20 patients with Cross K- wire (Group B) pinning technique of fixation. Results: The average follow-up period for patients in lateral K wiring technique  was 12.23 ± 1.9 months while that for patients in cross K wiring technique was 11.26 ± 2.5 months. This difference was not found to be statistically significant.  As per the Flynn criteria, 13 patients in group A had excellent results, 5 patients  had good results and 2 patient  had fair result. In group B, 12 patients had excellent results, 7 patients  had good results and 1 patients (20.0 %) had fair results. No patients in either group had a poor result. Conclusion: Both lateral and cross k wire fixation are similarly effective techniques for stabilising supracondylar humerus fractures, with comparable functional, radiological, and aesthetic results.

A prospective comparative study of functional and radiological outcome in percutaneous trans-olecranon fossa four cortex purchase lateral pinning versus cross-pinning in displaced supracondylar fractures of humerus in children

Somashekara S.A, Deepak H.R, Sunkappa S.R Somashekar Doddabhadre Gowda, Manoj Gidaganti

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 871-879

Traditional treatment with closed reduction and application of plaster slab or cast is
inappropriate in the case of displaced supracondylar fractures of humerus as this method may
potentially lead to malunion & subsequent elbow deformity, as it is difficult to obtain
satisfactory reduction and to maintain the reduction due to distraction forces acting at the
elbow. Our study involved 40 children who had sustained displaced supracondylar fractures
(Gartland-Type III) who were treated in the Department of Orthopaedic at a Tertiary care
trauma center, between November 2018 to May 2020. 55% of our cases were in the age group
5-10 years, 60% were male & 40% female.
80% (n=32) of the cases had history of fall on outstretched hand, followed by 3% with fall on
flexed hand which is in concordance with the most common mode of injury established by
many studies. 70% of the cases had fracture of left supracondylar humerus as compared to
30% on the right side. 30 out 40 cases had postero-medial displacement of distal fragment &
remaining 10 cases had postero-lateral displacement.

Management of humeral shaft fracture: A comparative study between interlocking nail and dynamic compression plating

Dr. H. Manjunath, Dr. Vikrant Kulkarni, Dr. Punith Nanjesh, Dr. Shivaprasad A Bhat, Dr. Ullas Mahesh

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 11904-11909

Introduction: There is a debate about the choice of operative intervention in humerus shaft fractures requiring surgical intervention. A prospective, comparative study of management of acute humeral shaft fractures treated by antegrade interlocking nail fixation and dynamic compression plating was undertaken over a period of three years. Twenty patients of interlocking nailing and sixteen patients of plating were included after considering the inclusion and exclusion criteria. Functional scoring criteria were used for postoperative assessment and the average follow-up period was one year. A higher rate of excellent and good results and a tendency for earlier union was seen with the plating group in our series.

To Assess Prevalence of Supracondylar Fractures of Humerus Among Patients Visited to Tertiary Care Hospital

Vijay Sharma,Shakti Condil Sharma

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 172-175

Background: Supracondylar fractures of the humerus are the most common elbow
fractures in children and adolescents accounting for 50-70% of all elbow fractures.
Supracondylar fractures may result in significant neurovascular compromise. The
present study was conducted to assess the prevalence of supracondylar fractures of
humerus among the patients who visited to tertiary care hospital.
Materials and Methods: The present retrospective study was conducted among 110
cases of supracondylar fractures reported to the department of both genders. General
information such as name, age, gender etc. was recorded. In all patients, the reason of
fracture and type were recorded. Data was collected and the data were analysed in
SPSS version 22 for windows. P value less than 0.05 was considered statistically
Results: In the present study out of 110 patients, 59.09% were males and 40.90% were
females. Gartland type II was seen in 28 males and 18 females and Gartland type III in
37 males and 27 females. The common reason for fractures was roadside accidents seen
in 47.27%, domestic violence in 35.45% and fall in 17.27%.
Conclusion:The present study concluded that supracondylar fractures of humerus were
more common in males than in females. The common reason for fractures was roadside