Functional outcomes in humeral shaft fractures-Conservative management versus operative procedure

Abstract

Aim: To compare the functional outcomes of humerus fractures managed by conservative method versus operative procedures in reference to radiological evidence of bony union, final functional outcome and complications. Material and methods: Prospective randomized study was conducted on 30 patients with Humerus shaft fractures, admitted in the department of Orthopaedics, Government Medical College, Patiala. The patients had been randomly divided into two groups- conservative management or operative treatment, 15 in each group. Patients were followed up for 1 year for radiological, clinical outcomes and complications. Standard treatment for most humeral shaft fractures is non-operative functional bracing; however, certain clinical scenarios necessitate operative intervention. Thirty adult patients with a humerus shaft fracture who satisfied inclusion criteria were treated at Government Medical College, Patiala with either a functional brace (nonoperative treatment group) or compression plating (operative treatment group). Results: Most of the patients with humerus fractures presented after road side accidents. There is no significant difference in time of union in conservative management (12­±2.6 weeks) and operative management (11.7±2.8 weeks). Elbow ROM at fracture union was not significantly different between the 2 groups (average 120.3 degrees range, 80°-180° vs average 132, range, 25°-150°) in the nonoperative and operative groups, respectively (P=.5532). Malunion was more frequent in the conservatively managed patients (12.7%) as compared to the operative group (1.3%). Conclusion: All humerus fractures needs assessment for conservative or operative management depending on the fracture characteristics and patient expectations.