Published online Oct 18, 2022. doi: 10.5312/wjo.v13.i10.940
Peer-review started: October 4, 2021
First decision: January 11, 2022
Revised: March 28, 2022
Accepted: October 11, 2022
Article in press: October 11, 2022
Published online: October 18, 2022
Processing time: 377 Days and 12.9 Hours
Humeral shaft fractures are relatively common in adults. Rotational malalignment is reported as one complication but severe rotational deformity of the humerus is extremely rare. To our knowledge, only three cases of symptomatic humeral malrotation have been reported. There are sparse literature reports of humeral reconstruction correction.
We present a case of extreme rotational deformity of the humerus (180°) after humeral shaft fracture. The patient complained of pain and difficulties with activities of daily living. In addition, she found the deformity cosmetically unacceptable. Therefore, she was searching for surgical correction. Neurolysis of the radial nerve followed by derotational osteotomy of the humerus and internal fixation were performed. Postoperatively, the patient demonstrated transient iatrogenic radial nerve palsy which recovered completely during postoperative follow-up. The Disabilities of the Arm, Shoulder, and Hand score improved from 55 preoperatively to 16 at the final 2-year follow-up.
Single-stage radial neurolysis, derotational osteotomy and stable fixation is a feasible option to improve anatomic and functional problems of severely malrotated humeral shaft fractures.
Core Tip: We present a case of extreme rotational deformity of the humerus (180°) after humeral shaft fracture. The patient complained about pain and difficulties with activities of daily living. A neurolysis of the radial nerve followed by derotational osteotomy of the humerus and internal fixation were performed. Postoperatively, the patient demonstrated transient iatrogenic radial nerve palsy which had complete recovery at 2 years postoperatively. The Disabilities of the Arm, Shoulder, and Hand score improved from a preoperative 55 to a final 16 at the final 2-year follow-up.