[The effectiveness of functional bracing in the conservative treatment of humeral diaphyseal fractures].

OBJECTIVES

We evaluated the effect of functional bracing on union and functional results in the conservative treatment of humeral diaphyseal fractures.

METHODS

The study included 38 patients (21 males, 17 females; mean age 34.8 years; range 20 to 63 years) who were treated with functional bracing for humeral diaphyseal fractures. The fractures were in the right in 23 patients, and in the left in 15 patients. Radial paralysis was detected in eight patients. Two patients had open fractures (Gustilo IIIA). According to the AO system, there were 12 AO type A1 (31.6%), 11 type A2 (29.0%), 13 type A3 (34.2%), and two type B1 (5.3%) fractures. Functional bracing was applied after a mean of 2.4 weeks of fixation of the shoulder and elbow. The radiographic and functional results were assessed using the scoring system of Kwasny et al. The mean follow-up was 48 months (range 16 to 64 months).

RESULTS

Complete union was achieved in all the patients in a mean of 11.4 weeks (range 10 to 16 weeks). Radiographic and functional results were very good in 31 patients (81.6%) and good in seven patients (18.4%). A mean of 0.8 cm (range 0 to 1.8 cm) shortness developed after union. In none of the patients angulation exceeded 20 degrees in the anteroposterior plane and 10 degrees in the lateral plane. Complete healing was obtained in patients with radial paralysis within three months. No complications were encountered pertaining to functional bracing.

CONCLUSION

When choosing conservative methods, functional bracing should be primarily considered in the treatment of humeral diaphyseal fractures because of low complication but very high success rates.