Orthopedic Surgery Expert Opines on Malunion Stemming From Humerus Injury

ByVictoria Negron

|

Updated onFebruary 8, 2018

Orthopedic Surgery Expert Opines on Malunion Stemming From Humerus Injury

This case involves a cyclist who suffered a humerus injury while competing in an event. He passed over a large rock and fell off his bike, fracturing his humerus. The cyclist’s orthopedic surgeon treated him with a brace and monitored him closely for several months. Eventually, the orthopedist cleared the cyclist to remove the brace, claiming that his bones were in proper alignment. The cyclist experienced persistent pain in his humerus following the removal of the brace and decided to see another orthopedist. The second orthopedist discovered that the cyclist’s bones had not realigned properly and that had several splinters in his humerus. The cyclists required a number of surgeries to correct these issues. An orthopedic expert was sought to review the records and opine on whether there was a deviation in the standard of care.

Question(s) For Expert Witness

1. How would you treat patients like the one described above?

2. What are the indications for operative repair of a humerus fracture?

Expert Witness Response E-017978

inline imageI routinely treat patients with fractures similar to this patient's injury. These fractures are most commonly sustained in conjunction with a fall. Indications for operative repair of a humerus fracture must take into consideration the patient, the fracture itself, and surgeon-specific variables. Fracture issues include fracture reduction, adequate stability, fracture healing, and joint mobility. Patient issues include bone quality, general health/comorbidities, and functional demand/occupational requirements. Surgeon-specific variables include surgical skill and available equipment.

inline imageComplex humeral shaft fractures are classified by the Müller AO classification system as either simple, wedge, or complex fracture patterns. The description noted appears to be a complex pattern with either a spiral, segmental or irregular fragment composition. Operative stabilization would be indicated for an open fracture, in a patient unable to sit or stand, for irreducible displacement, obesity, or nerve injury. Delayed surgery is always possible. External fixation is usually indicated for unstable fractures as temporizing fixation or for loss of reduction. Closed reduction with nailing (intramedullary antegrade or retrograde) is indicated for unacceptable reduction, loss of reduction and failure to heal to name a few. Open or closed reduction with plating (plate and screws) is indicated for open fractures, unacceptable reduction, failure of fracture healing, vascular injury, radial nerve palsy, ipsilateral brachial plexus injury, obesity or large breast, and a requirement for early load bearing.

About the author

Victoria Negron

Victoria Negron

Victoria Negron has extensive experience in journalism and thought leadership in the legal space, with a background crafting content, whitepapers, webinars, and current event articles pertaining to the role of expert witnesses in complex litigation matters. She is a skilled professional specializing in B2B product marketing and content marketing. Currently, she serves as an Enterprise Product Marketing Manager at Postman, and previously held the position of Technical Product Marketing Manager at Palantir Technologies, where she developed her skills in launch strategies, go-to-market strategy, and competitive analysis.

Her expertise in content marketing was further refined during her tenure at the Expert Institute, where she progressed from a Marketing Writer to Senior Content Marketing Manager, and eventually to Associate Director of Content & Product Marketing. In these roles, she honed her abilities in digital marketing, SEO, content strategy, and thought leadership.

Educationally, Victoria holds a Master of Business Administration from the University of Florida - Warrington College of Business and a Bachelor of Arts in Literature, Art, and Hispanic Studies from Hamilton College. Her diverse educational background and professional experience have equipped her with a robust skill set in product marketing, content development, and strategic marketing initiatives.

Find an expert witness near you

What State is your case in?

What party are you representing?