Surgical Discussion

Patient positioning:  The patient was positioned supine on the operating table with the affected arm draped free to allow for manipulation and reduction of the fracture.

Anatomical surgical approach:  A limited anterolateral approach was utilized, involving a careful split of the deltoid muscle to access the fracture site. The rotator cuff was split and protected during the procedure. Direct clamping of the fracture fragments was performed, followed by placement of interfragmentary screws to maintain reduction.

The surgeon noted that using an intramedullary nail minimized exposure, blood loss, and risk to the radial nerve compared to plating. A straight nail was bent using a tabletop bender to match the natural bow of the humerus, addressing potential issues with coronal and sagittal plane alignment and preventing distal humerus fracture. This technique was highlighted as a unique approach by the surgeon.

Postoperative protocol:   Postoperative rehabilitation included early mobilization with a focus on regaining range of motion and strength. Weight-bearing restrictions were not specified, but emphasis was placed on a rapid return to function.

Follow up:   Not specified.

Orthopaedic implants used:   Intramedullary nail, 2.4 mm interfragmentary screws.