Pain in the arm after Open reduccion and Internal fixation of a humerus fracture

Patient

Q: Shattered humerus in left arm 10 july 2011,had orif surgery which was more complicated than anticipaited on 22 august 2011, im still in terrible pain,muscle spasms and feelings as to electric shocks ,the pain goes to my wrist and fingers and stiffness,although i do exercises on my arm

Doctor

A:    Possibly you are experiencing a complication of the fracture: Radial nerve injury , which occurs in up to 18% of humeral shaft fractures. Most of these nerve injuries are neurapraxic (reversible nerve damage) or axonotmetic  (reversible axonal damage)types, 90% of which resolve to at least grade IV strength in 3-4 months. Four months has been noted to be an adequate period for humeral shaft fractures to heal. The nonunion rate reportedly varies from 1-15%. The other complication is the  nonunion  for humeral shaft fractures and it has  been associated with transverse fractures, as well as with such factors as fracture distraction, soft-tissue interposition, inadequate shoulder immobilization, and decreased shoulder motion. Medical factors that decrease the union rate include diabetes mellitus, corticosteroid use, older age, poor nutritional status, obesity. ORIF with compression plates and screws, with or without the aid of bone grafting, is considered to be the treatment of choice for most established nonunions. I can recommend you a re evaluation by your orthopedic surgeon and keep doing rehab to increase the range of motion, control pain, use therabands of progressive strenghts and start flexibility and stretching exercise to progressively built muscle strenght and mobility (i.e. towel behind back, finger walking up the wall, etc.).
 

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