Edited by Brendan Striano, Grace Xiong, and Harry Lightsey - 7/1/2021
Descriptors
Spiral, transverse, comminuted
Exam Pearls
Upper extremity neurovascular exam
Good assessment of radial nerve function
Examine medial arm for poke-hole open injuries
Workup
Radiographs: AP/Lat XR Humerus (add Shoulder or Elbow if fracture extends either way)
Other imaging: UE CT angiogram if concern for vascular compromise
Labs: None
Other: None
Management
Need for acute intervention: Immobilization without reduction.
Weight-bearing and range of motion: NWB UE, no ROM at shoulder or elbow, ROMAT wrist and distal
Type of immobilization: Coaptation splint
Admission or discharge status: Discharge with 1 week follow up in trauma clinic for alignment check and discussion regarding surgery v. non-operative management
Anticoagulation: None
Antibiotics: None
Surgical Indications
Absolute: Open fracture, ipsilateral forearm fracture (floating elbow)
Relative: Polytrauma pts w/ LE injuries (permit earlier UE weightbearing)
Not an Indication: Radial nerve palsy in closed fracture. These should have standard management for a closed fracture as above.