PMC3863509_01
Original internal rotation view showing a spiral fracture at the junction of the middle and distal thirds of the left humerus.
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Anterior-posterior and lateral radiographs showed that he had a spiral fracture with a butterfly fragment at the junction of the middle and distal thirds of the humeral shaft (Figure 1).
Intraoperative imaging showing excellent closed reduction and internal fixation with nonlocked, flexible intramedullary nails inserted in a retrograde fashion.
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Biplanar fluoroscopy confirmed excellent reduction of the fracture and proper positioning of the nonlocked flexible intramedullary nails (Figure 2).
(a) External rotation radiograph showing abundant callous formation, maintenance of fracture alignment, and position of nonlocked flexible intramedullary nails. (b) External rotation radiograph one year after surgery illustrating removal of the implant, remodeling of fracture alignment, and excellent alignment of the humeral shaft.
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Radiographs showed abundant callous formation and alignment remained unchanged (Figure 3(a)). One year postoperatively, the patient had returned to full pitching duties in game situations as well as scout leagues (Figure 3(b)).
Anterior-posterior and lateral radiographs of the left humeral shaft at 10-year followup. The patient has near anatomic alignment in the coronal plane and a 10-degree anterior bow in the sagittal plane.
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Radiographs taken 10 years postoperatively showed fully remodeled healing with near anatomic alignment in the coronal plane and a 10-degree apex anterior bow in the sagittal plane (Figure 4).