Date: Sun, 05 Sep 1999 14:50:12 +0800

Subject: Proximal humeral 3rd fracture

Could anyone give me the safe corridors to insert ex-fix pins on the proximal to middle third fractures of the humerus. The fracture is oblique just below the surgical neck. This is a gsw (shotgun). Any input is highly appreciated. Thank-you.


Reply at: Orthopaedic Trauma Association forum

Date: Sun, 05 Sep 1999 09:17:22 +0200

From: Peter Schandelmaier

There is a French Book , Translated into english from Springer Verlag 1987 ISBN 3-540-17127-4/0-387-17127-4; Faure C, Merloz P; Transfixation

It has nice pictures and diagrams about EF of the upper and lower limb

Peter Schandelmaier, Hannover

Date: Sun, 05 Sep 1999 12:22:

From: Bill Burman

Kristiansen B; Kofoed H; Transcutaneous reduction and external fixation of displaced fractures of the proximal humerus. A controlled clinical trial. J Bone Joint Surg [Br] 1988 Nov;70(5):821-4 - Preliminary report (JBJS 69B 643 1987) illustrates ex-fix pin placement for proximal humerus fx

Fig 1
Fig 2

Also see: Mostafavi HR; Tornetta P 3rd; Open fractures of the humerus treated with external fixation; Clin Orthop 1997 Apr;(337):187-97 - Mainly gunshot wounds of humerus treated with ex-fix (1 comminuted proximal third fx)

Date: Tue, 7 Sep 1999 01:06:04 +0500

From: Alexander Chelnokov


In general one should place wires in sagittal plane on proximal humerus and in frontal plane on the lower third. The statement is mostly about transfixation with wires. For half-pins any antero- and posterolateral areas are safe except known location of radial nerve. Its track should be marked before pin/wire insertion. There are a number of manuals which present painted transsections of the humerus at different levels.

Best regards - Alexander N. Chelnokov, Ural Scientific Institute of Traumatology and Orthopaedics, Ekaterinburg 620014 Russia