Management of Osteoporotic Fractures of the Humeral Shaft

Abstract

Fractures of the humeral shaft are common, and their incidence has increased by nearly 300% in persons older than 50 years of age as compared with patients younger than this. Most fractures of the humeral shaft can be treated nonsurgically with functional bracing, resulting in acceptable healing. However, some patients and fracture patterns are more amenable to surgical fixation. Patients who are osteoporotic at the beginning of treatment may have a diminished potential for healing, and the osteopenia resulting from immobilization of their fracture and disuse of the affected arm can magnify this disadvantage. Elderly patients often have frail skin that is more susceptible to breakdown and ulcer formation, thus making the nonsurgical management of osteoporotic fractures of the humeral shaft a less desirable option in this population. Advances in modalities and techniques of internal fixation have improved the outcomes of surgical procedures for fractures of the humeral shaft in patients with poor bone quality. This article covers traditional nonsurgical treatments and discusses recent advances in the surgical management of osteoporotic fractures of the humeral shaft, and outlines strategies for their treatment.

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