Humerus Shaft Fractures Research Articles

Shaft of humerus fracture managed by anteromedial plating through anterolateral approach.

Objective: To assess the use of anteromedial plating in the shaft of humerus fractures concerning the union of fracture and to assess the frequency of complications associated with this approach. Study Design: Cross Sectional study. Setting: United Medical and Dental College, Shaheed Muhatarma Benazir Bhutto Medical College Lyari and Khairpur Medical College. Period: 15 January 2016 to 15 January 2019. Material & Methods: All the patients aged 18 years or over presenting with the shaft of humerus fracture were included in the study. The anterolateral approach was used to expose the fracture, and the plate was applied on the anteromedial surface of the humerus. Rodriguez Merchan criteria assessed the functional outcome. All the data was recorded on designated Performa and entered and analyzed by SPSS version 20. Results: Two hundred twenty-five patients of both sexes were included in the study. The mean age of the patients in the study was 38.06 ± 11.51. The mean union time of fracture in our study was 11.76 ± 2.72 weeks. Functional outcome was assessed using Rodriguez Merchan criteria excellent functional outcome was achieved in 165(73.3%) of the cases and good functional outcome in 58 (25.8%) of cases. A fair outcome was achieved in 2 (0.9%) cases. Conclusion: Anteromedial plating is the viable option for treating shaft of humerus fractures as it is associated with a high union rate and low or no complications.

The Holstein-Lewis humerus shaft fracture in children: are they different from adults?

Spiral fractures in the distal third humerus shaft (Holstein-Lewis fracture pattern) have been associated with high risk of radial nerve palsy in adults and surgical treatment is recommended as the treatment of choice to remove the entrapped nerve from the fracture site. But this association and treatment approach has not been evaluated in pediatric humerus shaft fractures. In a retrospective study, 38 pediatric patients with Holstein-Lewis fracture configuration were identified after a review of radiographs of 1609 patients with humerus shaft fracture. Age at initial presentation, sex, mechanism of injury, side involved, presence of any associated injuries, neurovascular status, radial nerve status, fracture management, and any complications were noted. Thiry-three (86.8%) patients with mean age 10.1 ± 3.7 years were successfully treated by closed methods. Five patients (13.2%) with mean age 15.2 ± 2.6 years underwent surgical treatment. Contrary to adults, no children/adolescents had radial nerve palsy at presentation. Radiographic healing was acceptable in all cases at latest follow-up. Holstein-Lewis fracture behaves differently in children with no increased risk of radial nerve palsy. Majority can be treated conservatively. The thick periosteum in children may offer protection to the radial nerve and may be responsible for the success of closed treatment.

Tips and tricks in interlocking nailing in distal one third humerus shaft and segmental fractures of humerus

Background: The conventional methods like conservative treatments are well accepted for managing shaft fractures of humerus. But this needs continuous frequent vigilance on the clinical and radiological follow up to see any displacements and may need to change the line of treatment requiring surgical intervention. Closed Interlocking nailing of humerus mid shaft is routinely done as frequently as open plating because of its encouraging results. Fractures of distal one third humerus shafts are challenging for nailing especially if there is comminution and segmental fracture with short distal segment. Distal humerus fractures can be stabilised with intramedullary interlocking nails, provided adequate length is available in distal segment. The aim of this study is to explain difficulties faced in closed interlocking nailing of distal one third and below distal one third humerus shaft and solutions to overcome them and remove the hesitancy of performing nailing without any complications in such circumstances in a closed technique with minimal surgical trauma. Materials and Methods: A prospective study of 27 patients with fracture of Humerus shaft at and below one third level fractures was done. They were treated by closed interlocking nailing in period of five years from 2014 -2019. These patients were followed up till fracture union & evaluated further postoperatively for finding its benefits over open plating. Results: In our study, the age varied from 25 to 68 years. The mean age of patients was 45 years. 18 were males (65%) and 9 were females (35%). The results were based on type of fracture and healing period, infection, stiffness of elbow, restriction of movements. The results were encouragingly excellent in clinical radiological and functional outcome. Conclusions: From our present study we conclude that closed nailing of distal humerus fracture is a reliable minimal invasive alternative procedures than extensive open reduction and plating. It is especially benef

Osteosynthesis in midshaft humerus fractures with plating versus interlocking intramedullary nailing

The humerus shaft fractures are treated conservatively for a long time, but now the operative treatment is becoming more common. But the choice of operative intervention in humerus shaft fractures requiring surgical intervention is still a debate. The present study compares functional and radiological outcome of compression plating and intramedullary nailing in management of humerus midshaft fractures. This prospective comparative study over a period of three years in management of acute midshaft humerus fractures with compression plating and antegrade interlocking intramedullary nailing was done. In the period of study total 19 cases with midshaft humerus fractures were included after satisfying the inclusion and exclusion criteria. These patients are randomized and then 10 patients were treated with compression plating and 9 patients were treated with interlocking nailing. Postoperative assessment was done and functional scoring was done by Rodríguez-Merchán criteria and radiological outcome was assessed by serial radiographs. The minimum follow-up period was of 6 months and functional score at the end of 6 month follow up was considered. In this study excellent and good results were relatively higher in compression plating group with less number of complications. However sample size is small in this study. Further such studies are needed.

Minimally invasive plate osteosynthesis for humerus diaphyseal fractures: A retrospective study

Introduction: Several authors have reported anterior bridge plating of humerus as an acceptable and satisfactory procedure for treatment for humerus shaft fractures.We evaluated the clinical, radiological and functional outcome of such fractures over a period of follow up of 12 months treated by MIPO technique.Materials and Methods: Twenty patients presenting to author institute on follow up with humerus shaft fractures treated with anterior bridge plating using MIPO technique between January 2015 – December 2018. In all cases 4.5 mm dynamic compression plate (DCP) was used. The surgery time, radiation exposure and time for union was noted using hospital records. The shoulder and elbow function was assessed using UCLA (The University Of California At Los Angeles)shoulder and Mayo elbow performance score respectively.Results: Out of the 20 patients, 14 were male and 6 females. The mean age was 38.2 years (range 20 to 68).14 out of 20 patients (70%) had dominant side fractured.Mean surgical time was 82.7 minutes (range 60-120 minutes). Mean radiation exposure counted as one second for C- arm exposure was 112 seconds (80-170). The mean time for union was 13.4 weeks (range10 -20 weeks). Shoulder function was excellent in 17 patients (85%) and good in remaining 3 patients (15%) according to the UCLA score.elbow function was excellent in 15 cases (75%) and good in 5 cases (25%).Conclusion: Anterior bridge plating ofhumerusis an effective treatment for humerus shaft fractures and as the surgeon keep on gaining experience in this technique, it becomes less time consuming.

Study of open reduction and internal fixation with medial plating of fracture shaft humerus

Background: Humerus shaft Fracture Surgical management (Open reduction and internal fixation) is a choice of treatment for early mobilisation and rehabilitation. In this series ORIF with Medial side plating of Shaft Humerus was done. Materials and Methods: A retrospective study of 30 Patients Operated with ORIF and medial side plating was carried out for fracture shaft of Humerus.The patients were evaluated at a mean of 39 months (Range of 12 to 66 months) for union time and clinical outcomes.Results: Mean time of Union was 24 weeks ranging from 16 weeks to 32 weeks. There was no case of non-Union in this study.Conclusions: Medial side Plating of Fracture shaft humerus has given excellent results in this study.

English

BACKGROUND This case series was conducted to evaluate the intraoperative and post-operative outcomes of fracture shaft of humerus managed by indirect reduction and minimally invasive plate osteosynthesis (MIPO) via anterior approach. METHODS In this case series 26 diaphyseal fractures of the humerus treated with MIPO, between June 2017 and February 2020 at a tertiary care hospital were included. All the patients were followed up for a minimum period of 2 years postoperatively. The objective was to evaluate these cases clinically for shoulder and elbow range of motion and document any complications. Other parameters such as duration of surgery and radiological time for fracture union were also documented. RESULTS The mean duration for surgery was 86.5 minutes. The University of California Los Angeles (UCLA) shoulder scoring system rated 18 patients (69.2 %) as excellent outcome, 07 patients (26.9 %) as good outcome, and 1 patient (3.8 %) as fair outcome. The MAYO Elbow Performance Scoring system rated 20 patients (76.9 %) as excellent outcome and 06 patients (23.1 %) as good outcome. About 96 % of patients achieved fracture union by the end of 16 weeks post-operatively (mean 13.4 weeks). No complications related to infection, iatrogenic radial nerve injury or implant failure were noted in the study. 4 cases had varus angulation deformity but did not affect shoulder or elbow function. CONCLUSIONS MIPO is a safe and effective technique for the management of diaphyseal humerus fractures, with early fracture healing, less risk of complications such as infection and iatrogenic radial nerve injury, along with a cosmetically acceptable scar. KEYWORDS Fracture Fixation, Fracture Healing, Humeral Fractures, Radial Nerve, Shoulder

Initial management of humeral shaft fractures with functional splints versus coaptation splints.

Humerus shaft fractures are commonly acutely immobilized with coaptation splints (CS), which can be difficult to apply and poorly tolerated by the patient. Functional splints (FS), which work on the same principle as functional braces, are an alternative to CS. The purpose of this study was to directly compare CS and FS in terms of application and fracture reduction. A retrospective review identified humeral shaft fractures managed nonoperatively with initial immobilization in a FS (n = 19) versus a CS (n = 15). In addition, 13 residents completed a blinded survey on splint application. The FS and CS groups did not differ in initial fracture angulation and translation on anteroposterior (AP) and lateral radiographs. Post-splint application, there was no clinically relevant difference in fracture angulation/translation between groups, and this persisted at the subsequent follow-up visit. All residents reported that the FS was easier to apply and took less time. This study results demonstrated the FS results in similar reductions in humeral shaft fractures as CS. A survey of residents found that the FS was easier to apply, took less time, and was better tolerated by patients. Subsequently, we prefer the FS over the CS for the acute management of humeral shaft fractures.

A prospective study of surgical management of shaft of humerus fracture in general population by humerus IMIL with compression device

Aim: A fracture of the humeral shaft is a very common event. Humeral shaft fractures are generally simple fractures of the mid-diaphysis. The incidence of primary lesion of the radial nerve in association with humeral shaft fracture is quoted at 11.8% on average. Compression at the fracture site is beneficial for fracture healing; this has been used whenever fractures are fixed internally using compression plates and screws. Similarly the use of this technique i.e Humerus IMIL with Compression Device can be beneficial for achieving compression while nailing for treatment of shaft of humerus fracture. Materials and Methodology: 20 Adult patients with traumatic humerus shaft fractures in Orthopaedic Department of Bapuji Hospital and Chigateri General Hospital attached to J.J.M. Medical College, Davangere, who were willing for surgery were admitted during the period of study. They were clinically and radiologically evaluated. Result: The most common age group in our study was 21-40 years with the mean age of 41.13 years. Out of 20 patients 15(75%) patients were male and 5(25%) patients were female. The most common mode of injury is RTA, i.e. 16(80%) patients out of 20. This also shows the nature of involvement of Humerus shaft fractures as a part of a polytrauma patient. Right side is more commonly involved than the left. i.e.11 (55%) out of the 20 cases. In this study, the most common site of injury was Middle/3 a total of 15(75%) patients, next most common being upper/3- middle/3 junction - 5(25%). In this study the most commonly experienced type of fracture was Transverse type 14 (70%) patients, 2nd most common was Oblique fractures in 6 (30%) patients. In our study a total of 15 patients (75%) had no complications relating to surgery or post-surgery. 2(10%) cases were having shoulder stiffness which is most common complication. In our study we found that 16 patients (80%) had full range of shoulder movements. Others 4(20%) had 100-300 of residual abduction which accordingly hampered the functional outcome. In our study, 19 (95%) patients had solid union in less than 26weeks. Conclusion: Internal fixation of fractures of the shaft of humerus with interlocked intramedullary nail with compression device gives good results with satisfactory result as it allow early mobilization and early recovery with minimal soft tissue damage.

Comparison of outcome of shaft humerus fracture: Anterior bridge plating versus posterior plating vs humerus intramedullary nailing

Introduction: Shaft humerus fractures are complex injuries as their management requires stable fixation and adequate reduction. Management includes conservative cast application, intramedullary nailing, open reduction and internal fixation or MIPPO plating in form of Anterior Bridge plating.Aims and Objectives: Comparison of outcome of shaft humerus fracture treated by: Anterior bridge plating versus posterior plating versus intramedullary humerus nailing. Materials and Methods: A retrospective clinical study was done on 40 patients with shaft humerus fractures treated with Anterior bridge plating and posterior plating and intramedullary nailing by trained surgeons at a tertiary trauma care centre in the Department of Orthopaedics, BJ medical college, Civil hospital Ahmedabad between Nov 2019 to Nov 2020. The mean follow-up study time was approximately 6 months. (1-12 months).Observation and Results: All the operated patients were followed up for mean period of 6 months months (range from 01 to 12 months). Clinical, physiological and ortho-radiological assessment was performed to observe and evaluate fracture stabilization and reduction and fracture healing and callus formation and range of movements.Conclusion: Adequate reduction with less operative time and less soft tissue damage and preservation of neurovascular with increased rate of union and early mobilization was seen with ABP plating. Nailing had same benefits except the decreased range of movement at shoulder.

Analysis of outcome following early exploration of radial nerve palsy associated with closed shaft of humerus fractures

Analysis of outcome following early exploration of radial nerve palsy associated with closed shaft of humerus fractures

Treatment Of Fracture Shaft Humerus By Intramedullary Interlocking Nail

The goal of this study is to evaluate surgical treatment outcomes of fracture shaft humerus by using intramedullary interlocking nail. Fifteen patients (ages ranged from 51 to 70 with an average age of 64.20 ± 6.338 years, (10 males and 5 females) with shaft humeral fractures from Beni-Suef University and General hospitals during the period from December 2012 to June 2014. The selected participants were treated with intramedullary interlocking nail. Patients were followed up for a mean of 9 (range 6–12) months. The mean length of hospital stay was 3 (range 1–5) days. All the fractures united radiographically after a mean of 14 (range, 12–20) weeks. Conclusion: That the majority of humeral shaft fractures can be treated safely and effectively by non-operative methods. However, for the subset of patients requiring surgical treatment, intramedullary nailing provides predictable means of achieving fracture stabilization and ultimate healing. Poor outcome in intramedullary interlocking nailing is attributable to rotator cuff tear and shoulder impingement and lack of expertise of surgeon.

A Rare Case of Comminuted Fracture Shaft Humerus with Intercondylar Extension with Monteggia Dislocation and its Management- A Case Report

Background: Monteggia fracture-dislocation is a rare entity in adults with an incidence of less than 1%. However a combination of fracture shaft humerus with distal intraarticular extension along with monteggia fracture dislocation in an ipsilateral upper limb is very hard to find and manage, owing to its rare presentation. Material: In this report we detailed the surgical management of comminuted fracture(splinter) of shaft humerus with intercondylar extension AO C2 with typeII monteggia fracture dislocation with the usage proper implants in an 25 year old male with a 3 year follow up. Result: It shows that the fracture united well at appropriate time period and elbow range of movements were satisfactory ranges from 20° to 130° with no limitation in supination and pronation. Conclusion: Such a complex elbow injuries are difficult to find in the literature. This study addresses the proper surgical management in terms of approach and usage of appropriate implants to improve the long term functional outcome when dealing with such a injuries.

Ways to improve external structures for osteosynthesis of distal humerus fractures (early results)

The results of the first clinical application of the developed external device for osteosynthesis of distal humerus fractures are presented. Purpose: to improve the extrafocal method of reposition and fixation of humerus shaft fractures at the level of the lower third, taking into account the anatomical and physiological features of the area damaged. Material and methods: Functional, basic fixing and repositioning capabilities of the previously used external device, its advantages and disadvantages are considered. A minimally invasive guided technique for external rod fixation in the treatment of low third humerus’ fractures is described. An improved version of the apparatus layout and transosseous osteosynthesis technology was used in 10 patients. The design of the device allows to eliminate the displacement of the humerus fragments, ensures the stability of their fixation, while maintaining the function of the elbow joint. The indications for the use of external fixation were extra-articular fractures of the humerus in the distal third - type 12A (n = 6), 12B (n =3) and 12C (n =1) according to the AO / ASIF classification. Results: The analysis of treatment outcomes showed that the technology of minimally invasive osteosynthesis allows to achieve positive results in most patients with a minimum of complications - 90.5 ± 3.3 points according to MEPS’s clinic method of assessing the function of the elbow joint. Conclusions: The developed device for transosseous osteosynthesis of distal humerus fractures, is the method of choice and can be widely used in traumatology and orthopedics.

The multi-modality approach in a case of fracture of the humerus with an ipsilateral floating knee: A case report

Ipsilateral fractures of humerus, femur and tibia is a rare entity. The number of fractures resulting due to road traffic accidents is on the rise. These Type of injuries usually occur due to high-velocity road traffic accidents. High-velocity road traffic accidents are associated with multiple bony injuries as well as injuries to various internal organs. These injuries are often difficult to manage due to their complex nature. Mostly multiple fractures are produced in ipsilateral limbs. This condition makes the management even more difficult. Hence a multi-modality approach is often required. A 55-year-old male sustained floating knee with ipsilateral shaft humerus fracture. After a three-staged surgical approach with three modalities for treating the compound injury, the patient had an excellent result with the full range of motion in the knee and complete coverage of wound. Compound floating injuries should be treated with simultaneous fixation of femur and tibia fractures to achieve early full range of knee motion with Vacuum-assisted closure followed by skin grafting for complete wound coverage.

A study of size of nutrient foramina of humerus of Gujarat region

Delayed union or non-union of fracture shaft humerus occurs if there is damage to nutrient artery of humerus during surgical procedure of open reduction of fracture or by displaced bone fragments of fracture or any soft tissue interposition. This implies vital role of nutrient artery of humerus in fracture healing. 200 human dried humeri were studied for its anatomy of size and number of nutrient foramina. Size of nutrient foramen and thereby size of nutrient artery was decided with use of hypodermic needle No. 20 G & No. 24 G from Eastern medikit Limited. Observations made were compiled and tabulated. In present study, out of 282 nutrient foramina, 98 (35%) were large sized. Single nutrient foramina were found on 63% of humerus which is indicative of single nutrient artery to humerus and amongst them 40% humerus having large sized nutrient foramina. 65% of large sized nutrient dominant foramina were found on humerus having more than one nutrient foramina. 60 (49%) large sized nutrient foramina were found on right side humerus which is points to more use of right arm. Orthopaedic surgeons treating opened or displaced fracture shaft humerus can very well prevent damage to nutrient artery of humerus with sound knowledge of size of nutrient foramina and thereby its artery and add to better prognosis of fracture healing.

Operative Management of closed fracture shaft humerus: comparative study between MIPPO anterior bridge platting Vs conventional ORIF

Aim: Operative treatment of shaft humerus fracture continues to evolve. MIPPO is one of such emerging operative procedure which does give excellent results over conventional ORIF platting. We are comparing overall functional outcome and surgical complexity of MIPPO (Minimal Invasive Percutaneous Plate Osteosynthesis) vs conventional ORIF (Open Reduction and Internal Fixation) by posterior approach in this study. Materials and Methods: A retrospective clinical study was done on 50 patients with shaft humerus fractures treated with MIPPO anterior bridge plating and posterior platting by trained single surgeon at a tertiary trauma care centre in the Department of Orthopaedics, BJ medical college, Civil hospital Ahmedabad between October 2016 and May 2018. Follow up data was collected and patients were called for clinical and radiological evaluation. Results: 24 of the 25 (96%) MIPPO patients and 22 of the 25 (88%) ORIF patients achieved union. Average union times for the MIPPO and ORIF groups were 19.3 and 16.1 weeks respectively. At the end functional outcome of both the technique is as follows: the Mayo Elbow Performance Score (MEPS; range 95–100) were 90% in 20 cases (n = 20) operated with conventional ORIF posterior plating and 20 cases operated with MIPPO plating which is excellent scores. Two cases operated with ORIF posterior plating and three cases with MIPPO plating are showing a good MEPS score. Conclusions: Even though MIPPO is surgically demanding, fracture hematoma is not disturbed in it therefore it gives better and fast union than conventional ORIF. Keywords: Conventional ORIF, MIPPO platting, Fracture, Humerus.

Median nerve injuries associated with humerus shaft fractures in children

Abstract Purpose and background Humeral shaft fractures associated with median nerve palsy in children are not commonly seen and reported in the literature. The purpose of this retrospective study is to discuss the injury pattern, treatment options, nerve recovery, and functional outcome in these injuries. Methods We treated twelve children with median nerve palsy between 2012 and 2015. We analyzed the clinical presentations, radiological features, fracture type, displacement, treatment modality, nerve recovery pattern, time to bone union, functional outcome, 2-point discrimination (PD), range of movements, DASH score, and complications interpreted. Results The mean follow-up was 67.3 (range 59–80 months). 7/12 patients with median nerve injury recovered with hanging U slab/Shoulder immobilizer/Functional brace. Three patients who had median nerve entrapped at the fracture site required microsurgical nerve repair, and two patients required neurolysis alone. 11/12 patients (92%) had an excellent motor and sensory recovery (M5/S4) with a full range of movement. All patients achieved an excellent radiological union. The mean time to bone union was 13.5 weeks (range 11–18 weeks). The mean time for complete median nerve motor recovery in 11 patients was 25.4 weeks (range 22–26 weeks), and sensory recovery was 30.4 weeks (24–42weeks). The mean 2PD was 5.4 mm (range 5–7 mm). THE mean DASH score was 5.2 (range 2.3–18.2). One patient had M2/S3 recovery because of a treatment delay of >180 days. Conclusions We can treat acute humeral shaft fractures associated with median nerve injuries with hanging U slab/Shoulder immobilizer/Functional brace to achieve a complete nerve recovery, good radiological union, and excellent functional results. In cases of delayed humeral shaft fractures with nerve entrapment and poor nerve recovery, neuroma excision and microsurgical nerve repair give excellent results. Level of evidence IV.

The epidemiology of infant shaft fractures of femur or humerus by incidence, birth, accidents, and other causes

BackgroundThe purpose of this population-based registry study was to analyze both birth-related femur and humerus shaft fractures and diagnosed later in infancy, as regards incidence, perinatal characteristics, other diagnoses, and reported accidents.MethodsChildren born in 1997–2014, diagnosed with a femur or humerus shaft fracture before age 1 year, were identified in the Swedish Health Registries. Rate of birth fractures were estimated by combining femur and humerus shaft fractures coded as birth-related with femur and humerus shaft fractures diagnosed during day 1–7 without registered trauma or abuse. Incidence was computed by comparing infants with femur or humerus shaft fractures to the total at-risk population.ResultsThe incidence for birth-related femur shaft fractures was 0.024 per 1000 children (n = 45) and that for birth-related humerus shaft fractures was 0.101 per 1000 children (n = 188). The incidence was 0.154 per 1000 children for later femur shaft fractures (n = 287) and 0.073 per 1000 children for later humerus shaft fractures (n = 142). Birth-related femur shaft fracture was associated with shoulder dystocia, cesarean, multiple birth, breech, preterm, and small-for-gestational age, while humerus shaft fracture was associated with maternal obesity, dystocic labor, shoulder dystocia, vacuum-assisted delivery, male sex, multiple birth, breech, preterm, large-for-gestational age, birth weight > 4000 g, and injury of brachial plexus. A bone fragility diagnosis was recorded in 5% of those with birth-related or later femur shaft fractures. Among infants with birth-related humerus shaft fractures, 1% had a bone fragility diagnosis; the figure for later fractures was 6%. Maltreatment diagnosis was associated with later fractures of both types, especially among those aged < 6 months, where approximately 20% (femur) and 14% (humerus) of cases, respectively, were associated with abuse. Fall accidents were reported in 73 and 56% among those with later femur and humerus shaft fractures, respectively.ConclusionThis study provides data on epidemiology, birth, parental characteristics, and reported accidents in relation to femur and humerus shaft fractures during infancy. Few children had a bone fragility diagnosis. Fall accidents were the main contributor to femur or humerus shaft fracture during infancy; however, the proportion of fractures attributed to maltreatment was high in children under 6 months.

Variation in management of humeral and clavicular shaft fractures amongst fellowship trained orthopedic traumatologists

BackgroundThere exists a wide variety of opinions on the appropriate management of diaphyseal humeral and clavicular fractures amongst orthopedic surgeons.The purpose of this study is to determine if there is a preference amongst orthopedic traumatologists on treatment of diaphyseal humerus and clavicle fractures with respect to various patient populations.MethodsA 6-question survey was created using Surveymonkey.com and distributed via the Orthopedic Trauma Association (OTA) website to fellowship trained orthopedic surgery traumatologists to survey the preferred management of a simple oblique middle 1/3rd diaphyseal humerus fracture and a middle 1/3rd displaced diaphyseal clavicle fracture in the following 3 clinical settings: a healthy laborer, an older patient with co-morbidities, and if the surgeon themselves sustained the injury. The ratio of operative to non-operative management was calculated for all 6 questions. A chi-square value was performed to determine if the results are clinically significant based on the clinical scenario.ResultsThere was 56 responses to the survey that were included in the analysis. Overall, there was a statistically significant trend towards surgical management of the surgeon’s own diaphyseal humerus fractures (55%) compared to that of healthy patients (41%) and those with medical comorbidities (21%) (p = 0.02) A similar trend was noted for operative management for diaphyseal clavicle fractures by the surgeon on their own fractures (43%) compared to that of healthy patients (38%) and those with medical comorbidities (18%) (p = 0.02).ConclusionWhile there are an increasing number of relative indications for treatment of diaphyseal humerus shaft and clavicle fractures, the results of this survey indicate that fellow-ship-trained orthopedic trauma surgeons prefer surgical management of simple humerus and clavicular fractures in young, healthy patients as well as in themselves.