Purpose: To present transversal data (demographic and clinical) on isolated humeral shaft fractures (HSFs) in Latin American countries. Methods: Patients were enrolled between December 2015 and April 2017 at 11 medical institutions from six Latin America countries. Inclusion criteria: Age ≥18 years and a closed, isolated 12A, 12B, or 12C fracture (Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) classification). The patients’ demographic, comorbidity, and other baseline data were recorded. The outcome measures included the basal results of the research and the associations among the demographic factors, fracture features, and type of treatment applied. Results: A total of 123 patients were included. There was a preponderance of men (61.8%), whose mean age was significantly lower than that of the women (31.48 vs. 60.55). Overweight or obesity was present in 61.0% of women; 56.1% of patients were sedentary, 75.6% were nonsmokers, and 74.0% had no chronic disease. The type or treatment (operative/nonoperative) was not significantly associated with the patient’s or fracture’s characteristics. Falls and traffic accidents were the main causes of HSFs. Intramedullary nailing treatment was performed significantly more often in women, elderly patients, patients who did not participate in sports, and patients participating in only home activities. Minimally invasive plate osteosynthesis was performed significantly more frequently in men and in those who were self-employed. Open reduction internal fixation was performed significantly more often when the cause of the fracture was a traffic accident and when radial nerve palsy was present. Conclusion: The demographics and etiological differences observed in comparison to the current literature show the importance of regional studies for both preventive measures and educational guidance.
Nonunions of pediatric subtrochanteric femur fractures are exceedingly rare and have to date not been reported in the literature. We present the case of an 11-year-old boy who developed such a nonunion after open reduction internal fixation using a pediatric locked proximal femur plate. Using an adult proximal humerus locking plate, adequate proximal fixation of the nonunion was obtained. Furthermore, previously placed distal screw holes were safely bridged and the biomechanical environment around the nonunion site improved. Uneventful healing was possible with the use of adjuvant bone grafting. No short- or midterm complications occurred. Although other implants can certainly be adapted to a use different than that of its original design, the present case suggests that adult proximal humerus locking plates may be a safe option for revision surgery of the proximal pediatric femur.
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