FUNCTIONAL TREATMENT OF HUMERAL FRACTURES IN ADULTS

Abstract

Introduction: In this study we aimed to evaluate our clinical, functional and radiological results in humeral fractures which we treated by functional arm cast followed by functional brace.
Patients and methods: 48 patients (48 fractures) with a mean age of 42.8 (ranges: 16-73) years at the time of injury were included in this study. 41 (%85.4) of them had closed and 7 (%14.6) of them had open fractures. Radial nerve palsies were detected in 4 (%8.3) cases at initial examination following injury. All fractures were treated with cast splint and functional cast brace in an average of 25.6 (21-33) days following injury. Afterwards functional treatment was continued with thermoplastic polyethylen braces. Radiological and functional results were evaluated in the last follow-up examination. Functional evaluation was performed using Hunter’s criteria. Healing time of fracture and angulation of fracture in both planes (anterio-posterior and mediallateral) were assessed radiologically.
Results: Nonunion was detected in 3 (%6.3) cases. Union was obtained in a mean of 13.6 (ranges:8-21) weeks in remaining patients. A mean of 4.5° (3°-8) varus, 5° (3°-7°) valgus, 4.5° (3°-8°) anterior angulation and 3.7° (3°-5°) posterior angulation were detected in 15, 2, 13 and 3 fractures respectively. No shortening was detected in any patients. Four patients were Hunter G3, 2 were G4 and 43 were G5 functionally. All radial nerve palsies healed in a mean of 13.3 (12-15) weeks.
Discussion: We believe that early functional cast application followed by polyethylene brace usage after subsidince of oedema helps obtaining patient cooperation to the treatment, prevents skin problems and controls fracture angulation.