Risk factors associated with failure of treatment of humeral diaphyseal fractures after functional bracing.

OBJECTIVES

To assess humeral shaft nonunions after functional bracing and to identify any risk factors contributing to this outcome.

MATERIALS AND METHODS

Seven men and 12 women were retrospectively studied that had been treated for at least three months in a functional brace and had developed a clinical and radiographic nonunion. Patients' charts and radiographs were reviewed to evaluate fracture patterns, mechanisms of injury, associated health problems, and associated injuries.

RESULTS AND CONCLUSIONS

The results indicate a trend toward nonunion in patients with the following risk factors: obesity (37%); a history of cigarette smoking (53%); metabolic bone disease (32%); cardiovascular disease (37%); short oblique fractures (89%); open fractures (26%); and fractures of the proximal third of the diaphysis (68%). We recommend counseling these patients on the possible increased risk of nonunion from functional bracing and considering the option of operative fixation.