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VOLUME 17 , ISSUE 2 ( May-August, 2022 ) > List of Articles

Original Article

Multifocal Humeral Fractures: Clinical Results, Functional Outcomes and Flowchart of Surgical Treatment

Michelangelo Scaglione, Francesco Casella, Edoardo Ipponi, Federico Agretti, Simone Polloni, Michele Giuntoli, Stefano Marchetti

Keywords : Bone screws, Elbow, External fixators, Fracture fixation, Humeral fractures, Intramedullary, Segmental, Shoulder

Citation Information : Scaglione M, Casella F, Ipponi E, Agretti F, Polloni S, Giuntoli M, Marchetti S. Multifocal Humeral Fractures: Clinical Results, Functional Outcomes and Flowchart of Surgical Treatment. 2022; 17 (2):81-87.

DOI: 10.5005/jp-journals-10080-1559

License: CC BY-NC-SA 4.0

Published Online: 28-07-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Aim and objective: Multifocal fractures of the humerus are rare. The aim of our study is to evaluate the effectiveness of surgical treatment and propose a modification to the Maresca–Pascarella classification. A flowchart for surgical treatment is provided. Materials and methods: Thirty-one patients with multifocal humeral fractures were treated and evaluated. The Maresca–Pascarella classification was used. All were treated using with either plates and screws, external fixation or intramedullary nailing. Functional outcomes were evaluated using the QuickDASH test, the University of California – Los Angeles (UCLA) shoulder score and the Mayo elbow performance score (MEPS). Results: There were 12 Type A, 17 Type B, 1 Type C and 1 of combined fractures of the proximal and distal epiphysis. Of the 31 patients, 5 were lost to the follow-up (FU), 1 died of pulmonary embolism (PE) and the remaining 25 had a mean FU of 19.8 (7–35) months. Three patients had radial nerve damage and 1 went to a non-union that required further surgical intervention. The mean QuickDASH score was 15.7, the average UCLA shoulder score was 26.3 and the mean MEPS elbow score resulted to be 83.0. Conclusion: Although multifocal fractures are severe injuries, patients are able to recover good functionality if treated judiciously. Clinical significance: We proposed a standardised surgical approach based on the fracture characteristics, site and a modified Maresca–Pascarella classification.

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