Redwan Mohammed, Almouslem Amanda, Habib Zain, Arifuzaman Mohammed, Iskandar Yasser
Trauma and Orthopaedics, North Manchester General Hospital, Manchester, GBR.
Hospital Medicine, Damascus University, Damascus, SYR.
Cureus. 2025 Aug 11;17(8):e89837. doi: 10.7759/cureus.89837. eCollection 2025 Aug.
This was a prospective case series to evaluate the clinical and radiological outcomes of treating closed humeral shaft fractures in adults using a functional brace.
Twelve adult patients (mean age: 36 years; range: 16-70 years) with closed humeral shaft fractures meeting the inclusion criteria were initially managed with a U-shaped slab for two weeks, followed by a functional brace until radiological union was achieved. Clinical and radiological assessments were conducted weekly during the first month post-bracing, and biweekly thereafter until union. Clinical outcomes were evaluated using Hunter's criteria. Shoulder and elbow functions were assessed using the Constant-Murley Score (CMS) and Mayo Elbow Performance Score (MEPS), respectively. The shoulder and elbow range of motion (ROM) was measured at final follow-up. Radiological alignment was assessed in the coronal and sagittal planes at initial presentation and at the end of treatment.
All 12 fractures (100%) achieved union at a mean of 10 weeks (range: 7-12 weeks). According to Hunter's criteria, eight patients (66.7%) had excellent outcomes (Grade V), and three patients (25%) had very good outcomes (Grade IV). The mean CMS was 91.8, with nine (75%) patients scoring above 90. The mean MEPS was 96.2. Final angular displacement averaged 5.6° in the coronal plane and 1.5° in the sagittal plane. Spontaneous correction of displacement was observed without manipulation. No significant correlation was found between final angular displacement and functional outcomes (p > 0.05).
Functional bracing for closed humeral shaft fractures in adults results in a high union rate and excellent clinical and radiological outcomes. It is a safe and effective treatment option for this injury.
这是一项前瞻性病例系列研究，旨在评估使用功能性支具治疗成人闭合性肱骨干骨折的临床和放射学结果。
12例符合纳入标准的成人闭合性肱骨干骨折患者，最初使用U形石膏固定两周，随后使用功能性支具直至达到放射学愈合。在佩戴支具后的第一个月每周进行临床和放射学评估，此后每两周进行一次评估直至愈合。使用亨特标准评估临床结果。分别使用Constant-Murley评分（CMS）和梅奥肘关节功能评分（MEPS）评估肩部和肘部功能。在最终随访时测量肩部和肘部的活动范围（ROM）。在初始就诊时和治疗结束时评估冠状面和矢状面的放射学对线情况。
所有12例骨折（100%）均在平均10周（范围：7 - 12周）时达到愈合。根据亨特标准，8例患者（66.7%）获得优秀结果（V级），3例患者（25%）获得良好结果（IV级）。CMS平均为91.8，9例（75%）患者得分高于90。MEPS平均为96.2。最终冠状面角位移平均为5.6°，矢状面为1.5°。观察到位移自发矫正，无需手法复位。最终角位移与功能结果之间未发现显著相关性（p > 0.05）。
成人闭合性肱骨干骨折采用功能性支具治疗可获得高愈合率以及优异的临床和放射学结果。这是治疗该损伤的一种安全有效的选择。
