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This is a presentation of a case of fracture shaft of humerus in an adult with bad local skin conditions in the form of abrasions and CLWs which is a relative contra indication for open surgery. He was treated with closed reamed humerus nailing and the patient just came once for follow up for his hand fixator removal. He was so comfortable doing all the activities that he came for follow up only after two years that too for implant removal. Here are the function at 2 years as well as the steps of implant removal to avoid damage to the rotator cuff.
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A Humerus Fracture Case
• 26 year old male H/O RTA• Sustained Fracture of the right humeral shaft with
multiple CLWs and abrasions.• Ipsilateral hand was also involved in the injury with
multiple fractures of metacarpal bases and CLWs.• Treated with Closed Humerus reamed Nailing.• Ex Fix for the hand.• Came only once for follow up for the removal of
External fixator@ 8 weeks, then again after 2 years
Hand Injury treated with JESS
Healed multiple abrasions and CLWs
IMPLANT REMOVAL
8 mm Incision over earlier Entry scar
Negotiating Awl tip into the nail under C arm
Passing Extraction Bolt once tract made with Awl
Extraction Bolt Fixed not properly in another view, Subsequently reapplied
attempted different views of the shoulder
Removal of Proximal locking boltDistal Bolt was already lying out of the bone
otherwise should be removed before this
Nail being extracted
After Extraction
Removal of distal bolt lying in the soft tissue
Thank You