Comparative results of bracing and interlocking nailing in the treatment of humeral shaft fractures

Abstract

A comparison was made between 44 humeral fractures treated conservatively with functional bracing (Group 1) and 45 treated by operation with a locking nail (Group 2). Thirty-eight of the 44 patients in Group 1 (86%) and 22 of the 45 patients in Group 2 (47%) regained full movement of the shoulder joint. The functional end results were somewhat better in Group 1 although over 90% of patients in both groups were able to clasp their fingers behind their necks and to reach up their backs without restriction. Two patients developed a pseudarthrosis in Group 1, and 2 patients in Group 2 required operative revision due to a haematoma in 1 case and as a result of an infection in the other. There were 6 cases of primary radial nerve damage in both groups, and 6 had to be decompressed operatively. Residual sensory and motor disturbance remained in 2 patients in Group 1. Both methods are useful for the treatment of humeral shaft fractures. We advocate functional bracing as the method of choice if no contraindications exist.