Study on outcome of fracture shaft of the humerus treated non-operatively with a functional brace

Mani, K.C. Kapil; Sagar, Dayananda; Rijal, Laxman; Govinda, K C; Shrestha, Binaya Lal

doi:10.1007/s00590-012-0982-3

Cited by 26 publications

(15 citation statements)

References 14 publications

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“…Sarmiento et al ( 10 ), in 2000 demonstrated that using functional bracing for treating closed fractures of the humeral diaphysis resulted in a high rate of union due to the hydraulic impacts of the soft tissues. However, considerable limitations in shoulder and elbow mobility and certain residual angular deformities have been reported with functional bracing ( 5 , 9 , 10 ) which makes returning to usual daily activities difficult.…”

Section: Discussionmentioning

confidence: 99%

“…Humeral shaft fracture is one of the common injuries encountered in orthopedic surgery ( 1 ) accounting for 1% - 5% of all fractures ( 2 - 4 ). Although nonoperative treatment of humeral shaft fracture is associated with satisfying clinical and functional outcomes in most cases ( 5 - 8 ), usually results in varus deformity and limitation of shoulder and elbow motion in some patients ( 5 , 9 , 10 ). Thus, orthopedic surgeons prefer operative management due to early return to function and low compliance of the patients.…”

Section: Introductionmentioning

confidence: 99%

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Treatment of Humeral Shaft Fractures: Minimally Invasive Plate Osteosynthesis Versus Open Reduction and Internal Fixation

et al. 2015

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Background:The optimal technique for operative fixation of humeral shaft fractures remains controversial and warrants research.Objectives:The purpose of the current study was to compare the functional and clinical outcomes of conventional open reduction and internal fixation (ORIF) with minimally invasive plate osteosynthesis (MIPO) in patients with fractures in two-third distal humeral shaft.Patients and Methods:In the current prospective case-control study, 65 patients with humeral shaft fractures were treated using ORIF (33 patients) or MIPO (32 patients). Time of surgery, time of union, incidence of varus deformity and complications were compared between the two groups. Also, the university of California-Los Angeles (UCLA) shoulder rating scale and Mayo Elbow performance score (MEPS) were used to compare the functional outcomes between the two groups.Results:The median of union time was shorter in the MIPO group (4 months versus 5 months). The time of surgery and functional outcomes based on the UCLA and MEPS scores were the same. The incidence of varus deformity was more than 5° and was higher and the incidence of nonunion, infection and iatrogenic radial nerve injury were lower in the MIPO group; however, the differences were not significant.Conclusions:Due to the shorter union time, to some extent less complication rate and comparable functional and clinical results, the authors recommend to use the MIPO technique in treating the mid-distal humeral shaft fracture.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Treatment of Humeral Shaft Fractures: Minimally Invasive Plate Osteosynthesis Versus Open Reduction and Internal Fixation

et al. 2015

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“…For instance, nonoperative treatment, such as functional bracing, has been considered an efficient method for isolated HSFs 10–15. However, it might be associated with some complications, such as nonunion, angulation, malunion, shoulder impingement, skin abrasion, limited range of motion (ROM), and long-lasting treatment 7,14–18…”

Section: Introductionmentioning

confidence: 99%

<p>Humeral shaft fracture: a randomized controlled trial of nonoperative versus operative management (plate fixation)</p>

Khameneh¹,

Abbasian²,

Abrishamkarzadeh³

et al. 2019

ORR

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PurposeThis randomized controlled trial was conducted to investigate the outcomes of humeral shaft–fracture management with the functional Sarmiento brace (nonoperative) versus open reduction internal fixation (ORIF).MethodsSixty humeral shaft–fracture patients with a minimum age of 18 years were randomly assigned into two groups: operative treatment with open reduction–internal fixation (ORIF) or functional brace (Sarmiento). A similar postoperative rehabilitation program was applied for all subjects for the next 12 months. The outcomes of each method were measured in terms of nonunion rate, union time, “quick” Disabilities of Arm, Shoulder, and Hand (DASH) questionnaire scores, and rate of complications, such as malunion, infection, and radial nerve injury.ResultsThe two groups had similar baseline characteristics, including age, sex, smoking status, and type and mechanism of fracture. The mean union time was about 4.8 weeks shorter in the ORIF group (13.9 weeks in operative group versus 18.7 weeks in nonoperative group), indicating a definite significant superiority (p=0.001) of ORIF management to functional Sarmiento bracing. However, a comparison of quick DASH scores revealed a borderline-significant difference between the groups (p=0.065). Additionally, we found that treatment of humeral shaft fractures using functional bracing was associated with slightly higher risk of nonunion; however this was not significant (p=0.492).ConclusionAccording to the present findings, there is remarkable superiority of ORIF over functional Sarmiento bracing in the management of patients with humeral shaft fracture.

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“…These include poor follow up rates, leading to amplification of proportions of non-union patients, who will present back to follow up more reliably than healed unions [ 9 - 11 ]. In addition, differences in protocols of applying a humeral brace across different countries and institutions have been observed in many studies, such as the use of U-slab, hanging cast, or backslab initially (and for different periods of time) before brace application, all of which could affect final outcomes [ 8 , 12 , 13 ]. In the literature, the reported time to union varies 8 to 30 weeks with an average of 10.7 weeks [ 1 , 2 , 12 , 14 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

Treatment of Midshaft Humerus Fractures Using Early Functional Bracing: Results and Prognostic Factors

Arealis¹,

Faria²,

Kučera³

et al. 2021

Cureus

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Study on outcome of fracture shaft of the humerus treated non-operatively with a functional brace

Abstract: Functional bracing for the treatment of fractures of the humeral diaphysis is associated with a high rate of union with nearly normal elbow motion and some restriction of shoulder motion.

Cited by 26 publications

References 14 publications

Treatment of Humeral Shaft Fractures: Minimally Invasive Plate Osteosynthesis Versus Open Reduction and Internal Fixation

Treatment of Humeral Shaft Fractures: Minimally Invasive Plate Osteosynthesis Versus Open Reduction and Internal Fixation

<p>Humeral shaft fracture: a randomized controlled trial of nonoperative versus operative management (plate fixation)</p>

Treatment of Midshaft Humerus Fractures Using Early Functional Bracing: Results and Prognostic Factors

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