Holstein–Lewis fracture

Description

Holstein–Lewis fracture: simple spiral fracture of the distal third of the shaft of humerus with distal bone fragment displaced and the proximal end deviated toward the radial side with an increased risk of acute radial nerve palsy

The Holstein-Lewis humeral shaft fracture constitutes 7.5% of all humeral shaft fractures and was associated with an increased risk of acute radial nerve palsy compared with other types of humeral shaft fractures, 22% versus 8% (P < 0.05) [Ekholm et al]

History

1962 – Arthur Holstein and Gwilym Lewis presented a paper at the annual meeting of the American Academy of Orthopedic Surgeons, Chicago. They presented 7 cases with this fracture type associated with radial nerve palsy

1963 – Holstein and Lewis published a study of 341 consecutive distal humerus fractures in the JBJS, 6 patients with radial nerve palsies were found, 5 of whom showed this specific fracture pattern. They hypothesized that the high association with radial nerve palsy was that the fracture occurred at the site of radial nerve runs through the lateral intermuscular septum in direct contact with the bone and with limited mobility.

Associated Persons

• Arthur Holstein (1914 – 2000)
• Gwylim Lewis (1914 – 2009)

References

• Holstein A, Lewis GM. Fractures of the humerus with radial-nerve paralysis. J Bone Joint Surg Am. 1963 Oct;45:1382-8. [PMID 14069777]
• Ekholm R, Ponzer S, Törnkvist H, Adami J, Tidermark J. The Holstein-Lewis humeral shaft fracture: aspects of radial nerve injury, primary treatment, and outcome. J Orthop Trauma. 2008 Nov-Dec;22(10):693-7. [PMID 18978544]
• Shao YC, Harwood P, Grotz MR, Limb D, Giannoudis PV. Radial nerve palsy associated with fractures of the shaft of the humerus: a systematic review. J Bone Joint Surg Br. 2005 Dec;87(12):1647-52. [PMID 16326879]
• Somford MP, Wiegerinck JI, Hoornenborg D, van den Bekerom MP, Eygendaal D. Eponyms in elbow fracture surgery. J Shoulder Elbow Surg. 2015 Mar;24(3):369-75. [PMID 25595361]