BACKGROUND: Non-operatively treated fractures of the humeral diaphysis have a high rate of union with good functional results. The objective of this study is to find out the outcome of fractures of the humeral diaphysis treated with a functional brace that permits motion of shoulder and elbow joints and progressive use of the injured extremity. MATERIALS AND METHODS: This was a descriptive analytical study in patients of 16 years and above with closed fracture shaft of humerus treated with a functional brace that permits the motion of shoulder and elbow joints. The fracture arms were initially stabilized with U slab or hanging cast for an average of 11 days before application of brace. Radiographs were made at each follow-up visit until the fracture union occured. Angulation at fracture site, motion at shoulder and elbow joint were measured at the time of removal of brace. RESULTS: One hundred and five out of 108 fractures (97.2 %) were united with mean duration of 12.16 weeks (range, 7.5-19.3 weeks). Radial nerve injury was present in 6 cases (5.5 %). Varus angulation of ≤15° was present in 90.9 % out of 99 patients, while no angulation was present in 6 cases (5.7 %) out of 105 patients. Apex anterior angulation of ≤10° was present in 100 % out of 48 patients, whereas apex posterior angulation of ≤10° was present in 94.1 % out of 51 patients. CONCLUSION: Functional bracing for the treatment of fractures of the humeral diaphysis is associated with a high rate of union with nearly normal elbow motion and some restriction of shoulder motion.
BACKGROUND: Non-operatively treated fractures of the humeral diaphysis have a high rate of union with good functional results. The objective of this study is to find out the outcome of fractures of the humeral diaphysis treated with a functional brace that permits motion of shoulder and elbow joints and progressive use of the injured extremity. MATERIALS AND METHODS: This was a descriptive analytical study in patients of 16 years and above with closed fracture shaft of humerus treated with a functional brace that permits the motion of shoulder and elbow joints. The fracture arms were initially stabilized with U slab or hanging cast for an average of 11 days before application of brace. Radiographs were made at each follow-up visit until the fracture union occured. Angulation at fracture site, motion at shoulder and elbow joint were measured at the time of removal of brace. RESULTS: One hundred and five out of 108 fractures (97.2 %) were united with mean duration of 12.16 weeks (range, 7.5-19.3 weeks). Radial nerve injury was present in 6 cases (5.5 %). Varus angulation of ≤15° was present in 90.9 % out of 99 patients, while no angulation was present in 6 cases (5.7 %) out of 105 patients. Apex anterior angulation of ≤10° was present in 100 % out of 48 patients, whereas apex posterior angulation of ≤10° was present in 94.1 % out of 51 patients. CONCLUSION: Functional bracing for the treatment of fractures of the humeral diaphysis is associated with a high rate of union with nearly normal elbow motion and some restriction of shoulder motion.
Authors: Sundeep Khosla; L Joseph Melton; Mark B Dekutoski; Sara J Achenbach; Ann L Oberg; B Lawrence Riggs Journal: JAMA Date: 2003-09-17 Impact factor: 56.272