Comparative results of non-operative and operative treatment of humeral shaft fractures / 北京大学学报(医学版)

ABSTRACT

Objective:To compare the difference between non-operative and operative treatment of humeral shaft fractures.Methods:From March 2005 to October 2012,252 cases of humeral shaft fractures were treated and were adequately followed up.According to the treatment methods,the patients were divided into 2 groupsthe non-operative group and the operative group.In the non-operative group,there were 76 cases treated with plaster/small splint fixation,meanwhile there were 176 cases treated with inter nal fixation either by plating or by nailing in the operative group.The follow-up parameters includedfracture healing rate,fracture union time,complications rate,Constant-Murley shoulder score and Mayo elbow score.Results:The mean follow-up period was (31.24 ± 20.06) months (ranging 6 to 103 months).There were no statistical differences in age,open fracture number,fracture site and Arbeitsgemeinschaft ftir Osteosynthesefragen (AO) classification between the non-operative group and the operative group.The fracture healing ratethe non-operative group96.1％ (72/76),the operative group97.7％ (172/176),P =0.46;the fracture union timethe non-operative group(10.24 ± 2.93) weeks,the operative group(10.69 ± 2.51) weeks,P =0.22;the complication ratethe non-operative group5.3％ (4/76),the operative group15.3％ (27/176),P =0.03.The complications includednonunionthe non-operative group3.95％ (3/76),the operative group2.3％ (4/176),P =0.434;radial nerve palsiesthe non-operative group0％ (0/76),the operative group5.7％ (10/176),P =0.035;bone splitthe non-operative group0％ (0/76),the operative group1.7％ (3/176),P =0.556;elbow stiffnessthe non-operative groupl.3％ (1/76),the operative group0.6％ (1/176),P =1.000;shoulder painthe non-operative group0％ (0/76),the operative group5.1％ (9/176),P =0.061.The Constant-Murley shoulder scorethe non-operative group97.37±4.94,the operative group96.34 ± 6.88,P =0.244.The Mayo elbow scorethe non-operative group99.80 ± 1.72,the operative group99.49 ± 2.73,P =0.923.Conclusion:The results of non-operative treatment of humeral shaft fractures appeared with excellent results with lower complications rate compared with that of the operative treatment.