Atypical Transverse Midshaft Humerus Fracture in an Octogenarian: Surgical Nuances and Functional Outcome Following...

Humeral shaft fractures in elderly patients typically present as spiral or comminuted patterns due to age-related osteoporosis and low-energy mechanisms. A transverse midshaft fracture in this age group is quite uncommon and poses its own management challenges. Conservative approaches may be insufficient in such atypical cases.

We report the case of an 80-year-old female who sustained an isolated transverse mid-diaphyseal humerus fracture following a low-energy fall. Given the instability of the fracture configuration and apprehensions regarding adherence to bracing, we elected for surgical fixation utilising a locked intramedullary nail. A minimally invasive antegrade nail was employed with a deltoid-sparing incision. The nail was aligned flush to prevent shoulder impingement. Proximal and distal interlocking screws were used at both ends to guarantee torsional stability in osteoporotic bone. The patient exhibited remarkable radiological union and achieved nearly full range of motion through early mobilization and physiotherapy.

This case highlights the successful management of an atypical fracture pattern in a geriatric patient through thoughtful surgical planning. Locked antegrade intramedullary nailing with attention to fracture-specific surgical nuances does provide a reliable solution in such uncommon scenarios.