Fractura de la diáfisis del húmero

A fracture of the humeral shaft is defined as a break in the continuity of bone tissue in this anatomical region, which is delimited by the square method in both proximal and distal directions. From an epidemiological standpoint, humeral shaft fractures represent 1.5% of all fractures. They exhibit a bimodal pattern: in young adults (thirties) they occur due to high-energy trauma, and in older adults (seventies) due to low-energy trauma. Sixty percent of fractures are observed in patients over 50 years of age. Sixty percent are located in the middle third of the shaft, 30% in the upper third, and 10% in the lower third. The mechanism of injury can be of two types: high energy—caused by direct trauma due to accidents, falls from heights, physical assaults, and sports; and low energy—caused by indirect trauma from falls onto the hand or elbow, which predominates in older patients. The positive diagnosis of patients with this traumatic condition is based on three pillars: the patient's history, the clinical presentation, and complementary tests. Regarding the latter, the use of imaging is particularly important, specifically arteriography in cases of vascular injury and electromyelography in cases of radial nerve injury. The most frequent associated injuries are glenohumeral dislocation, floating elbow, and open fractures. Several classifications are used for this fracture, including those described by Garnavos and those based on fracture morphology. Treatment is either conservative or surgical. Conservative treatment is used in 90% of cases and consists of the use of splints, such as those described by Watson Jones, and brachial casts. The most commonly used surgical modalities include plates and screws, intramedullary fixation, and external fixation, each with its own specific advantages, disadvantages, indications, and contraindications. The most frequently reported complications in patients with humeral shaft fracture are: radial nerve injury, loss of fixation, pseudoarthrosis, vascular damage, and malunion.