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General Orthopaedics

UNION RATES OF HUMERAL SHAFT FRACTURES TREATED WITH FUNCTIONAL BRACING

The South West Orthopaedic Club (SWOC) Spring Meeting



Abstract

The aim of this audit was to assess the union rate of humeral shaft fractures treated conservatively in a functional brace in our unit, compared to a “gold standard” of 98% as reported by Sarmiento (JBJS 1977).

A retrospective clinical and radiographic review of 155 closed humeral shaft fractures managed with a humeral brace from 2005–2012 was performed. Pathological fractures and patients under 18 were excluded. The mean age was 60 (18–94) with 45 males and 72 females. 15 (10%) patients under 18 and 8 (5%) pathological fractures were excluded; 15 (10%) patients were lost to follow up.

Of the remaining 117 fractures, 83 (71%) went on to union and 34 (29%) developed a non-union. Mean time to union was 131 days (47–622). 80% of distal fractures and 75% of midshaft fractures united but only 58% of proximal fractures went on to unite. There was no significant difference in union rates between multi fragmentary (> 3 parts) and simple fracture patterns (69% vs 71% respectively).

Our study suggests that a lower threshold for operative intervention of proximal third humeral shaft fractures may be required.