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The first 25 slides, exactly as they appear. The full deck has 89 content slides.
Orthopaedics
Fracture of the Humeral Shaft
Built from Tang — Orthopaedic Trauma Vol 1: Upper Extremity
What’s inside
6 sections · 89 slides
Foundations
What the injury is, who gets it, and the anatomy that governs treatment
- What this topic covers
- The humeral shaft, in plain terms
- How common, and where
- Two ages, two mechanisms
- What deformity the arm can tolerate
- The company this fracture keeps
- Blood supply — why the fracture usually heals
- Anatomy of the humerus and the radial nerve
- The radial nerve groove — the danger line
- Triangular cross-section and where the plate sits
- Shape dictates the plate — matching hardware to bone
- Tension side — a subtle mechanical rule
- How the bone breaks
- The AO classification of humeral shaft fractures
- Reading the AO code — a fracture's ID number
- Type A, B, C at a glance
- Bedside assessment — before any X-ray
- Imaging — seeing the whole injury
Surgery: When and the Core Toolbox
Deciding to operate, and the three plating techniques every fixation uses
- When conservative care is not enough
- What the operation is trying to achieve
- Choosing the surgical route
- Three plating techniques — the whole toolbox
- Compression plate technique (part 1)
- Compression plate technique (part 2)
- Compression plate — squeezing simple breaks
- Lag screw and protection plate technique
- Lag screw + protection plate — for angled breaks
- Bridging plate technique
- Bridging plate — leaving the mess alone
Open Approaches
Reaching the shaft safely — anterolateral, lateral, and posterior routes
- Anterolateral approach — patient positioning
- Anterolateral approach — the upper two-thirds
- Anterolateral approach — proximal and distal windows
- Why split the brachialis down its middle
- Anterolateral fixation — postoperative X-rays
- Matching technique to fracture type via this approach
- Lateral approach — positioning and incision
- Lateral approach — surface incision line
- Lateral approach — for the middle and distal 1/3
- Lateral approach — protecting the LCNF
- Lateral approach — the radial nerve exposed
- Lateral approach — postoperative X-rays
- Contouring the plate for the twisted distal shaft
- A practical lesson — the shaft is not straight
- Posterior approach — positioning
- Posterior approach — surface incision line
- Posterior approach — the triceps and the radial nerve
- Posterior approach — the route to the distal 1/3
- Distal 1/3 fracture fixed via the posterior route
Minimally Invasive Plating (MIPO)
Two small windows, a plate slid under muscle, biology preserved
- MIPO — proximal and distal working windows
- What MIPO is, and why it helps
- MIPO case — Type B1 fracture, technique steps (part 1)
- MIPO case — Type B1 fracture, result (part 2)
- How MIPO reduction and fixation work
- Plate length — longer is stronger, counter-intuitively
- Screw spacing and density around the fracture
- Screw density — leave the middle empty
Intramedullary Nailing
A rod down the centre of the bone — antegrade technique, step by step
- Nailing — beach chair position
- Nailing — the concept and the setup
- Nailing — the acromial incision
- Nailing — the entry point through the rotator cuff
- Finding the entry point — and respecting the cuff
- Nailing — reduction and passing the guidewire
- Passing the nail across the break
- Nailing — distal interlocking screw
- Nailing — correcting rotation before proximal locking
- Locking the nail and undoing rotation
- Nailing — burying the nail below the tuberosity
- Nailing — repairing the rotator cuff
- Finishing safely — protect the shoulder
Complications
Non-union and radial nerve palsy — causes, prevention, and cautionary cases
- Non-union — when the bone fails to unite
- Non-union after plating — the revision that worked
- Preventing non-union — matching biology to mechanics
- Nailing pitfall — proud nail, limited motion (part 1)
- Nailing pitfall — cuff wear on arthroscopy (part 2)
- Long spiral fracture — the wrong job for a nail
- Unstable fixation rescued by added external support
- Radial nerve palsy — usually a good-news story
- Key takeaways
- References (1/3)
- References (2/3)
- References (3/3)
- Orthopaedic Trauma Surgery — Volume 1: Upper Extremity