Isolated simultaneous bilateral humeral shaft fractures in a healthy victim of a road traffic crash: a case report and review of literature.

BACKGROUND

Humeral shaft fractures constitute 1-5% of all adult fractures and 13% of humerus fractures. They usually result from low- or high-energy mechanisms. While several cases of bilateral proximal end-segment humerus fractures have been reported, simultaneous bilateral humeral shaft fractures are rare in previously healthy individuals. When they do occur, they are often accompanied by other injuries. Isolated simultaneous bilateral humeral shaft fractures following traffic accidents are exceptionally rare injuries. To our knowledge, only one such case has been reported. We present a case of isolated simultaneous bilateral humeral shaft fractures in a healthy woman following a traffic accident in which she sustained no other significant injuries. The aim is to emphasize the importance of healthcare providers being vigilant for uncommon injury patterns and being prepared to address them in ways that minimize disability.

CASE PRESENTATION

A 43-year-old African (Yoruba) woman arrived at our hospital's Accident and Emergency Department 30 minutes after the passenger minibus, in which she was seated in the rear left row (driver's side), collided with a trailer. She was not wearing a seat belt. She remained conscious but complained of pain and an inability to lift both arms. Clinical and radiographic evaluation revealed an abrasion on her right shoulder and bilateral humeral shaft fractures (HSFs). There were no other injuries. The Injury Severity Score was 10. She underwent closed nailing of both fractures on the 4th day post-injury and was discharged on the 7th day post-surgery. She had an excellent functional outcome, and radiographic union was noted on her 12-week postoperative follow-up.

CONCLUSION

This case demonstrates a rare consequence of unsafe transportation systems in a developing country. It underscores the necessity for healthcare workers in such nations to be ready to manage uncommon injury patterns using limited resources in a manner that encourages early functional recovery and reduces mortality and disability.