Holstein Lewis Fracture Treatment

There is a high incidence of radial nerve injury associated with humeral shaft fracture especially involving the holstein lewis fracture located in the third of the humeral shaft. 20 degrees angulation in sagittal plane 30 degrees varusvalgus angulation 2-3 cm limb shortening Klenerman JBJS 1966.

Galeazzi Fracture Dislocation Medical Field Radiology Bone Fracture

Debride the wound.

Holstein lewis fracture treatment. Majority can be treated conservatively. If the fracture is open and associated with nerve injury the nerve could be lacerated and exploration should be done. All 6 patients with associated radial nerve palsy recovered.

The overall outcome regarding fracture healing radial nerve recovery and function was very good regardless of the primary treatment modality that is operative or nonoperative treatment. Treatment of the humeral shaft fractures is usually nonoperative with a coaptation splint for. If open associated with radial nerve injury.

The resultant neuropraxia to the radial nerve will result in loss of sensation in the radial distribution and a wrist drop deformity. Humeral shaft fractures are common fractures of the diaphysis of the humerus which may be associated with radial nerve injury. Lateral plating is recommended if a radial nerve injury is apparent and requires further explorationtreatment ie Holstein-Lewis fracture.

The fractures of all conservatively treated patient went into union. Surgical management is indicated in such cases. The Holstein-Lewis humeral shaft fracture was associated with a significantly increased risk of acute radial nerve palsy.

Diagnosis is made with orthogonal radiographs of the humerus. Holstein- Lewis fracture. Radiographic healing was acceptable in all cases at latest follow-up.

With an anterolateral approach you will explore the nerve between the brachialis and the brachioradialis. Of whom 2 were treated. Treatment can be nonoperative or operative depending on location of fracture fracture morphology and association with other ipsilateral injuries.

In addition the multi-fragmented subgroup of those rare fractures run the risk of non union after operative treatment as there is soft tissue dissection during surgery which disrupts the blood flow to the fracture fragments. - plate fixation of humerus. Conservative treatment of the Holstein Lewis humeral shaft fractures remains a very attractive option because there is no risk of iatrogenic radial nerve injury or infection.

Some degree of malalignment is well tolerated. The thick periosteum in children may offer protection to the radial nerve and may be responsible for the success of closed treatment. Typically a straight LCP requires bending to fit the lateral aspect properly.

May cause palsy seconary to tethering of radial nerve in lateral intermuscular septum or entrapment in fracture site. Fracture location ie Holstein-Lewis fracture illustrated Since many radial nerve lesions recover spontaneously and do not require any surgical treatment it is important to differentiate between nerve disruption and neurapraxia to decide whether to explore the nerve or not. When treating an open fracture associated with a radial nerve injury you will debride the wound and an exploration of the nerve and fixation of the fracture should be done.

The Holstein-Lewis humeral shaft fracture was associated with a significantly increased risk of acute radial nerve palsy. Humerus Holstein Lewis Fracture - Everything You Need To Know - Dr. After nearly 50 years no additional information is available to refine this knowledge.

Good outcome general found with. Nabil Ebraheim - YouTube. Among the patients with a Holstein-Lewis fracture 26 were treated surgically and 74 were treated conservatively.

The overall outcome regarding fracture healing radial nerve recovery and function was very good regardless of the primary treatment modality that is operative or nonoperative treatment. Holstein-Lewis fracture behaves differently in children with no increased risk of radial nerve palsy. Distal 13 shaft fracture.

Associated with Holstein Lewis fracture. Exploration of the nerve and fixation of the fracture should be. Holstein - Lewis JBJS Am 1963 - series of 7 oblique distal third fractures with radial nerve injury - all were treated operatively - nerve in fracture gap in 2 impaled in 1 severed in 2 contused - in callus in 2 - advised against attempted closed reduction - risk of contusing nerve between fragments.

Ebraheims educational animated video describes the condition of a Holstein - Lewis distal. - posterior approach to. - Modified anterolateral approach for internal fixation of Holstein-Lewis humeral shaft fractures.

Pierces lateral intermuscular septum at juntcion of middle and distal thirds of the distance from the acromion to the lateral epicondyle. A Holstein-Lewis fracture is a fracture of the distal third of the humerus resulting in the entrapment of the radial nerve. Alternatively anatomic lateral distal humeral plates VA-LCP may be used.

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