Prognosis
With recent advances in emergency transport and orthopedic surgical technique, many patients with high-energy trauma survive their injuries and go on to complete, or near complete, recovery.
The nature, severity, and number of injuries dictate the prognosis for a given person.
Humeral fractures
Proximal humerus fractures usually heal well, but disruption of the vascular supply can lead to avascular necrosis (AVN) of the humeral head. Shaft (diaphyseal) fractures may be complicated by neurovascular injury (i.e., radial nerve injury) and nonunion.
Radial and ulnar fractures
Appropriate surgical intervention leads to satisfactory outcome for most of these injuries.
Femur fractures
Most isolated femur fractures heal well with appropriate treatment. However, a potential for severe complications exists and it is important to keep in mind that many femur fractures occur as part of severe multisystem trauma (i.e., motor vehicle accidents with multiple fractures and internal organ injuries). Proximal injuries may lead to femoral head AVN and may require hip arthroplasty. Massive bleeding, neurovascular injury, fat embolism syndrome, venous thromboembolic disease, and other complications may occur. If the patient survives the initial trauma, the outlook is generally good.
Tibial and fibular fractures
Operative management of tibial shaft fractures generally leads to good outcomes. Nondisplaced fractures generally heal well with conservative treatment. Open fractures are associated with high risk of infection, and compartment syndromes must be detected and treated early.
Isolated fibular fractures usually heal well with nonoperative management.
Healing of nonoperatively treated tibial shaft fractures has been shown to be delayed among smokers and (with transverse tibial fractures) among alcohol abusers.[118][119]
Use of this content is subject to our disclaimer