Houston Methodist. Leading Medicine

Shoulder FAQ


What is a Holstein-Lewis type of fracture? Evidently my father fell and this is what the doctor told him he has. Please explain.


Your father has broken his upper arm bone called the humerus. Holstein-Lewis tells us the location of the break: in the lower third of the bone, sometimes at the juncture of middle and distal third of the bone. This type of fracture usually causes a spiral fracture that curves around the bone rather than going straight across.

Holstein-Lewis fractures are often treated with bracing rather than a cast to avoid elbow stiffness. Nerve injury can occur if bone fragments pierce the nerve. One in five patients have nerve injury that usually gets better with time and healing (3 to 4 months). Surgery may be needed if there is delayed healing of the bone or nerve.

Michael J. DeFranco, MD, and Jeffrey N. Lawton, MD. Radial Nerve Injuries Associated with Humeral Fractures. In The Journal of Hand Surgery. April 2006. Vol. 31A. No. 4. Pp. 655-663.

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