Evaluation of Different Methods for Management of Humeral Diaphyseal Fracture

  • Ali Alias Ali, Zohair M. AL-Saffar
Keywords: fracture humerus, hanging arm cast, U shape cast, operative treatment.

Abstract

BACKGROUND:
Fractures of the humeral shaft account 3% of all fractures.
OBJECTIVE:
purpose of the present study is to study in a consecutive series of humeral shaft fractures; union rate, time
of union, rate of nonunion, evidence of malunion, shoulder and elbow joints function and symptoms after
each method, to confirm previously published results, and to study the effect of postoperative fracture
distraction in fracture union.
METHODS:
By using conservative and operative methods, we treated 54 patients who had a fracture of the humeral
shaft. 48 patients were available for follow-up, which ranged from 5 to 40 weeks.
RESULT:
The average age of patients was 31.39 yrs (ranges from 5 to 65 Yrs), 26 males and 22 females. From these
patients (42 were of close and 6 were of open fractures), the average time of union was 10.5 weeks for
conservative method and 8.4 weeks for operative method.
In non operative method approximately 41.66% of the patients (ten patients) had an excellent functional
result and an essentially full range of motion of the shoulder and elbow. 33.33% (eight patients) had a
good functional result but lacked 15 degrees of forward flexion of the shoulder, or less, or 5 to 15 degrees
of extension of the elbow. 8.3% (two patients) had a fair functional result but lacked more than 20 degrees
of motion in both shoulder and elbow joints (specially in elbow extension) with mild pain. 16.6% (four
patients) had a poor initial resulted secondary to instability that was due to nonunion of the fracture.
CONCLUSION:
Because of the low morbidity and high rate of success in conservative method and because statistically
there was no significant difference between the two methods (P value more than o.o5), we concluded that
the treatment of choice for diaphyseal fractures of the humerus is better to be by non operative method
unless there’s a clear indication for surgery.

Published
2012-01-02
Section
Articles