Abstract
Humeral shaft fractures, which make up about 3% of all fractures, can often be managed non-operatively, with outcomes ranging from good to excellent. Conservative management techniques include the hanging arm cast, U-slab coaptation splintage, thoracobrachial immobilisation, shoulder spica cast, skeletal traction and functional bracing. The outcomes of functional bracing and U-slab coaptation splint-age have been shown to be equally good, but Sarmiento et al reported that patients found functional bracing more acceptable. We compared the costs in time and money.
The U-slab coaptation splint is bulky and not uncommonly the slab slips or loosens, requiring repeated reapplication. We looked retrospectively at the frequency of U-slab reapplication in our outpatient setting, and multiplied the frequency of reapplication by the cost per unit and time per unit, comparing these parameters with those for functional braces.
Our study showed that in monetary terms U-slab coaptation was cheaper than functional bracing, but highlighted the hidden cost in terms of application time, additional imaging and rehabilitative physiotherapy. Functional bracing has the added advantages of single application, increased patient comfort and hygiene, more rapid rehabilitation of shoulder and elbow movements and ease of access for soft tissue dressing.
The abstracts were prepared by Professor M. B. E. Sweet. Correspondence should be addressed to him at The Department of Orthopaedic Surgery, Medical School, University of Witwatersrand, 7 York Road, Parktown, Johannesburg, 2193 South Africa
