Multiple problems occur for the triceps when this fracture occurs. This page is about the various possible words that rhymes or sounds like holstein lewis fracture. Humeral shaft fractures and radial nerve palsy mdedge. Humerus shaft fracture complicated by radial nerve. Ekholm r, ponzer s, tornkvist h et al 2008 the holstein lewis humeral shaft fracture. A holstein lewis fracture is a spiral fracture involving the distal third of the humerus which causes entrapment of the radial nerve.
Apr 06, 2020 a firewall is blocking access to prezi content. The overall outcome regarding radial nerve recovery, fracture healing and function was excellent regardless of the primary treatment modality, i. Humerus shaft fracture an overview sciencedirect topics. The study showed that the holstein lewis humeral shaft fracture was associated with a significantly increased risk of primary radial nerve palsy. Diaphyseal humerus fractures orthopaedic trauma association.
To evaluate the therapeutic outcome of artificial total hip arthroplasty tha with collum femoris preserving for hip joint disease in young and. Posterior compartment of the forearm brachial plexus anconeus muscle deep artery of arm radial sulcus. Jul 10, 2015 holstein lewis fractures involve the distal third of the humerus where the radial nerve spirals around from the posterior aspect of the humerus with a high incidence of associated radial nerve palsy. Holstein lewis fracture is a fracture of the distal third of the humerus resulting in entrapment of the radial nerve pathology. The icd code s423 is used to code holsteinlewis fracture.
This article is within the scope of wikiproject medicine, which recommends that medicinerelated articles follow the manual of style for medicinerelated articles and that biomedical information in any article use highquality medical sources. Use it for writing poetry, composing lyrics for your song or coming up with rap verses. A 21 year old woman sustained a throwers fracture of the distal humerus and radial nerve palsy while throwing a softball. Humerus fractures functional union acceptable deformity.
May cause palsy seconary to tethering of radial nerve in lateral intermuscular septum or entrapment in fracture. The study showed that the holsteinlewis humeral shaft fracture was associated with a significantly. Most frequently humeral shaft fractures occur as a result of a direct blow to the upper arm transverse fractures. Holstein a, lewis gb 1963 fractures of the humerus with. Please visit the project page for details or ask questions at wikipedia talk.
Since the triceps brachii and all muscles distal of the break are innervated by the radial nerve, they will be significantly affected by the fracture. Primary open reduction is the treatment of choice for this injury. Radial nerve palsy associated with closed humeral shaft fractures. Holstein lewis humerus fracture find, read and cite all the research you need on researchgate.
Nvs brachial plexus of the ul runs below the clavicles evaluate it. Holsteinlewis fracture litfl medical eponym library. The injury is a spiral fracture of the distal third of the humerus, typically as a consequence of blunt trauma, with the distal fragment displaced such that the proximal aspect is deviated radially. The holsteinlewis humeral shaft fracture was associated with a significantly increased risk of acute radial nerve palsy. It is named for arthur holstein born 1914 and gwylim lewis 1914. Gwylim bill lewis 1914 2009 was an american orthopedic surgeon. The possible mechanism of injury and the question of medicolegal responsibility are discussed. Most typical examples in an orthopaedic classification given in the previous section cannot be classified appropriately into any specific part of.
Holstein lewis fracture the holstein lewis fracture was first described by american orthopedic surgeons arthur holstein and gwilym lewis 5. Patients with a closed humerus fracture associated with primary. The holstein lewis humeral shaft fracture was associated with a significantly increased risk of acute radial nerve palsy. A comparison of functional bracing and plate fixation. Throwing sports have become increasingly popular outside of north america and bring with them a novel injury mechanism for clinicians. Information and translations of holstein lewis fracture in the most comprehensive dictionary definitions resource on the web. Look for skin tenting results in open fracture by perforating the skin or creating a necrotic area. Ap, 45 cephalic tilt shows sup\inf displacement nvs brachial plexus of the ul runs below the clavicles evaluate it. Jan 04, 2021 request pdf on jun 19, 2015, josie acuna and others published case report. Nothing humorous about this fracture emergency physicians. Humeral shaft fracture with radial nerve palsy has been a subject of debate since this entity was originally described by holstein and lewis in 1963. Astaysuture is placed in the distalmost apex of the split to prevent unwanted propagation and, thus, injury to the axillary nerve. The holsteinlewis humeral shaft fracture constitutes 7.
Holsteinlewis fracture wikipedia republished wiki 2. Typically, a straight lcp requires bending to fit the lateral aspect properly. A holstein lewis fracture is a fracture of the distal third of the humerus resulting in entrapment of the radial nerve. Modified anterolateral approach for internal fixation of holstein. The resultant neuropraxia to the radial nerve will result in loss of sensation in the radial distribution and a wrist drop deformity. As the radial nerve travels posterior to the humerus, it provides innervation to the dorsal upper arm muscles. Wheeless textbook of orthopaedics menu on humeral fractures. A fracture of the normal humerus in a healthy young adult most commonly results from significant direct trauma. The recommendation at that time was open exploration of the radial nerve as the large lateral bone spike had an association of nerve laceration and entrapment figure 7. Holstein and lewis affirm that radial nerve palsies are associated most commonly with spiral fracture 1 fig. Request pdf the holstein lewis humeral shaft fracture.
Final outcomes of radial nerve palsy associated with humeral shaft. Weve got 0 rhyming words for holstein lewis fracture. Ebraheims educational animated video describes the condition of a holstein lewis distal humeral fracture. As the radial nerve travels to the humerus, it provides innervation to the dorsal upper arm muscles. Humerus holstein lewis fracture everything you need to know dr. Mar 25, 20 the radial nerve courses along the spiral groove of the humerus and can be damaged with humeral shaft fractures. Neck of femur fractures nof are common injuries sustained by older patients who are both more likely to have unsteadiness of gait and reduced bone mineral.
Alternatively, anatomic, lateral distal humeral plates valcp may be used. Prof nabil ebraheim holstein lewis fracture is a spiral fracture involving the distal third of the humerus, which causes entrapment of the radial nerve. I think most would define successful fracture treatment as a functional union with minimal deformity. Mesh terms adolescent fracture fixation humans humeral fractures. Fractures of the humerus with radialnerve paralysis. The holsteinlewis hl subtype fracture58 is a spiral frac ture of the distal third of. Throwers fracture of the humerus with radial nerve palsy.
A holstein lewis fracture is a fracture of the distal third of the humerus resulting in the entrapment of the radial nerve. The holstein lewis humeral shaft fracture constitutes 7. Definition of holstein lewis fracture in the dictionary. Humeral shaft fracture radiology reference article. A case of a displaced spiral fracture of the distal third of the humerus is reported which had occurred during arm wrestling and was treated by open reduction and internal fixation. Large person with varus producing breasts and unbraceable arm. At the same time the apex of the distal fragment is moved proximally and radially, lacerating or trapping the radial nerve between the bone fragments.
Named after arthur holstein born 1914 and gwylim lewis 1914. The radial nerve originates from the posterior cord of the brachial plexus. Radial nerve palsy was present in 22% 6 of 27 of these patients and in 8% 27 of 344 in the non holstein lewis humeral shaft fractures. Holstein lewis humeral shaft fracture, its association with radial nerve palsy, and the. The exception to this rule is if the fracture to the humerus requires fixing in the first instance. Humerus holstein lewis fracture everything you need to know. A holsteinlewis fracture is a fracture of the distal third of the humerus resulting in entrapment of the radial nerve. May cause palsy seconary to tethering of radial nerve in lateral intermuscular septum or entrapment in fracture site. Some orthopedic surgeons do not feel as though holstein lewis fractures respond well to functional bracing and should instead undergo. Fractures that have additional definition criteria than merely localization often may be classified as subtypes of fractures, such as a holstein lewis fracture being a subtype of a humerus fracture. Along with arthur holstein eponymously affiliated with the holsteinlewis fracture, first described in 1963. Spiral fracture of the humerus caused by arm wrestling.
The resultant neuropraxia to the radial nerve will result in loss of sensation in the radial distribution and a wrist drop. Topics anterior approach to humerus anterior approach to shoulder arteries of the upper limb blood supply to the humerus classification of proximal humeral fractures condylar fractures distal humeral fractures holstein lewis fractures humerus humeral shaft fracture non union of humeral fractures pediatric humeral frx posterior. Our current concepts for this patient radial nerve. Oneinten patients with a closed humeral shaft fracture has an. Orif plate fixation distal for wedge fracture, intact. It should be noted that le fort fractures are often associated with other facial fractures, neuromuscular injury and dental avulsions. Fracture lower limb with fracture shaft humerus for. Lateral plating is recommended if a radial nerve injury is apparent and requires further explorationtreatment ie holstein lewis fracture.
Apr 22, 2016 humeral shaft fractures humeral shaft fractures account for approximately % of all fractures beaty 1996, zuckerman, 1996 usually the result of blunt trauma such as a fall or from highenergy trauma including motor vehicle accidents and gunshot injuries fracture displacement is the result of muscular forces 4. Holstein lewis fracture is a spiral fracture involving the distal third of the humerus, which causes entrapment of the radial nerve. Extraarticular distalthird diaphyseal fractures of the humerus. Fractures of the humerus with radialnerve paralysis j bone joint surg am. The purpose of this article is to present a case where a double flexor tendon transfer was used to restore thumb, finger and wrist extension in a patient who sustained a complete radial nerve transection secondary to a distal humeral shaft or holstein lewis fracture.
This fracture pattern is known as the holstein lewis humeral shaft fracture after the authors who first described the pattern in 1963 holstein and lewis, 1963. Holsteinlewis fracture usually uncountable, plural holstein lewis fractures a fracture of the distal third of the humerus resulting in entrapment of the radial nerve. It is named for arthur holstein born 1914 and gwylim lewis born 1914, american orthopedic surgeons who described it in 1963. This paper presents seven cases illustrating a humeral fracture syndrome complicated by radialnerve paralysis. As the radial nerve travels posterior to the humerus, it provides innervation to. It is named for arthur holstein born 1914 and gwylim lewis born 1914, american. The higher the impact strength, the more likely the fracture is to be comminuted 1. Delayed radial nerve palsy after closed reduction of a. Holsteinlewisfracture meaning best 1 definitions of. The majority of humeral shaft fractures present with a simple fracture pattern and. 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. Indirect trauma from a fall or a twisting action e.
Humerus holstein lewis fracture everything you need to. Aspects of radial nerve injury, primary treatment, and outcome the primary aim. Patients tended to be younger and had sustained highenergy trauma. Lewis fractures spiral fractures of the distal third of the humeral shaft that often entrap the radial nerve as it traverses the distal humerus, al though an. The more posterior rotator cuff tear can be accessed viatheposteriorraphe. A contemporary approach to the management of complex fractures of the distal humerus and their sequelae. Segmental fractures holstein lewis type distal fractures large person with varus producing breasts and unbraceable arm. Doubleflexor tendon transfer for radial nerve laceration. In that case, the nerve should be explored at the same time that fixation is performed. Humerus holsteinlewis fracture healthcare bones fractures.
275 449 58 75 140 27 1201 1050 702 1706 1234 1296 307 1188 1159 674 1113 679 1614 716 1775 482 1410 291 1635 1216