Presentation
21M motor vehicle accident. Front seat passenger, was holding grab handle. Car vs tree. Impact on passenger side. Examination: open wound, neuro-vascularly intact.
Patient Data
Left Gustillo 3b mid shaft humeral fracture with 12cm distal bone loss.
Extensive soft tissue gas and irregularity in the mid and distal upper arm. Fracture of the mid shaft of the humerus with absent distal humeral shaft. Fracture dislocation of the elbow joint with displaced humeral fragments. No evidence of fracture within the proximal radius or ulna.
Case Discussion
The ambulance service found a 12 cm fragment of humerus in a tree. The patient went to theatre for external fixation and multiple wound wash outs. Despite the proximity of the radial nerve to the humeral shaft, he still had all sensation and motor function in his hand and is planned for reconstruction.
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