Marijn Rutgers1, David Ring. 1. Massachusetts General Hospital, Orthopaedic Hand and Upper Extremity Unit, Boston, MA 02114, USA.
Abstract
OBJECTIVE: To determine humeral diaphyseal fractures at risk for nonunion with functional brace treatment. DESIGN: Retrospective case series. SETTING: A single surgeon's practice. PATIENTS: Forty-nine of 52 consecutive patients treated nonoperatively for an isolated diaphyseal fracture of the humerus during a 6-year period were followed until either union and full or near-full restoration of shoulder and elbow motion, or until 6 months had passed, or until a reconstructive surgery was performed (average follow-up 14 months; range 2 to 50 months). INTERVENTION: Functional fracture brace. MAIN OUTCOME MEASUREMENTS: Radiographic and clinical union. RESULTS: Union was achieved in 44 of 49 patients (90%) with no more than 15-degree loss of shoulder or elbow motion in any patient. Four of 14 proximal-third fractures (29%), one of 22 middle-third fractures (4%), and none of the 13 distal-third fractures failed to heal. CONCLUSIONS: Proximal-third long oblique fractures may be at greater than average risk for nonunion after functional fracture bracing. LEVEL OF EVIDENCE: Level IV (case series).
OBJECTIVE: To determine humeral diaphyseal fractures at risk for nonunion with functional brace treatment. DESIGN: Retrospective case series. SETTING: A single surgeon's practice. PATIENTS: Forty-nine of 52 consecutive patients treated nonoperatively for an isolated diaphyseal fracture of the humerus during a 6-year period were followed until either union and full or near-full restoration of shoulder and elbow motion, or until 6 months had passed, or until a reconstructive surgery was performed (average follow-up 14 months; range 2 to 50 months). INTERVENTION: Functional fracture brace. MAIN OUTCOME MEASUREMENTS: Radiographic and clinical union. RESULTS: Union was achieved in 44 of 49 patients (90%) with no more than 15-degree loss of shoulder or elbow motion in any patient. Four of 14 proximal-third fractures (29%), one of 22 middle-third fractures (4%), and none of the 13 distal-third fractures failed to heal. CONCLUSIONS: Proximal-third long oblique fractures may be at greater than average risk for nonunion after functional fracture bracing. LEVEL OF EVIDENCE: Level IV (case series).