Year: 2025 | Month: November | Volume: 12 | Issue: 11 | Pages: 266-271
DOI: https://doi.org/10.52403/ijrr.20251128
Closed Humeral Shaft Fracture with Osteomyelitis in an Elderly Patient Managed by Open External Fixation and Holistic Approach for Wound Management: A Case Report
Dhifo Indratama1, Melati Purnama1 Sari, Taufik Akbar2
1General Practitioner, Andalas University Hospital, Padang, West Sumatera
2Orthopedic and Traumatologic Surgeon, Andalas University Hospital, Padang, West Sumatera
Corresponding Author: Dhifo Indratama
ABSTRACT
Background: Subacute hematogenous osteomyelitis in closed fractures is rare but clinically significant, especially in elderly patients with delayed presentation. In rural areas, traditional bone manipulation before referral increases infection risk. Optimal care requires surgery supported by effective communication and wound care education.
Case Presentation: An 80-year-old woman developed swelling and purulent discharge two weeks after a fall treated by a bonesetter. Radiographs showed a closed midshaft humeral fracture with subacute osteomyelitis. She underwent open reduction, debridement, and open reduction external fixation (OREF). Postoperatively, structured wound care education was provided to patient and family, whose active role was essential due to limited access to orthopedic care.
Result: At six months, radiographs confirmed complete fracture union, infection resolution, and restoration of arm function. Family involvement was pivotal in maintaining wound hygiene, ensuring compliance, and sustaining patient motivation during recovery.
Discussion: This case highlights the value of family-centered care in infection management for elderly fracture patients. Evidence shows that engaging families improves adherence, reduces infection risk, and supports early detection of complications. Routine follow-ups also reinforce education and provide ongoing monitoring.
Conclusion: In elderly patients with humeral shaft fractures complicated by subacute osteomyelitis, combining surgical treatment with structured family-focused wound care education and regular follow-up optimizes both infection control and functional outcomes. Family engagement should be recognized as a cornerstone of holistic fracture management.
Keywords: osteomyelitis, closed fracture, family education, holistic wound management
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