Comparison between functional bracing and locked intramedullary nailing in isolated and closed humeral shaft fractures
Journal Title: Eklem Hastaliklari ve Cerrahisi - Year 2005, Vol 16, Issue 3
Abstract
Objectives: We retrospectively compared the treatment results of functional bracing and locked intramedullary nailing for humeral shaft fractures in two similar patient groups. Patients and methods: Sixty-seven patients were treated conservatively with a prefabricated functional brace (group 1, n=35, mean age 34 years) or surgically with a locked intramedullary nail (group 2, n=32, mean age 37 years) for acute, isolated, and closed humeral shaft fractures. The average time from injury to treatment was five days (range 2 to 11 days) in group 1, and four days (range 1 to 7 days) in group 2. The results were assessed according to the Constant-Murley shoulder scoring system. The mean follow-up was 15.2 months in group 1 and 16.3 months in group 2. Results: Hospitalization was significantly shorter in group 1 (mean, 7 days versus 21 days; p=0.001). The average time to union was 13.4 weeks in group 1, and 13.9 weeks in group 2 (p=0.5). Eleven patients (31.4%) and two patients (6.3%) developed an average varus angulation of 8.5° and 5° in group 1 and 2, respectively. Three patients (8.6%) had apex-anterior angulation (mean 7°), and one patient (2.9%) had 4° apex-posterior angulation in group 1. Three patients (8.6%) in group 1, and two patients (6.3%) in group 2 had abduction losses of less than 10°. External rotation of the shoulder decreased by less than 10° in two patients (5.7%) in group 1 and in two patients (6.3%) in group 2. Shortening (range 5 to 20 mm) developed in four patients in group 1. One patient (2.9%) with a transverse fracture developed nonunion in group 1. Prominence of the proximal end of the nail was seen in two patients (6.3%), one of which required removal. The results were all excellent or good in both groups, with an average score of 86.5 in group 1, and 85.9 in group 2 (p=0.7). Conclusion: Although both methods offer satisfactory results in the treatment of humeral shaft fractures, we recommend functional bracing as the method of choice unless it is contraindicated.
Authors and Affiliations
Ozcan Pehlivan, Omer Arpacioglu, Ahmet Kiral, İbrahim Akmaz, Mahir Mahirogullari, Haluk Kaplan
Keywords
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