Comparison of the results of treatment of humeral shaft fractures by different methods.

ABSTRACT

The aim of this study was to compare the functional results of non-operative and different operative techniques of managing humeral shaft fractures. The average follow-up was one year after the trauma in 61 patients with united fracture, where the initial method of treatment was the definitive one. The patients were divided into four groups 22 were treated with hanging cast, 20 with intramedullary nails, 10 with dynamic-compressive plates and screws and 9 with external fixators. We estimated the presence of bone union by radiographic and clinical evaluation and compared the results with Constant and Mayo scores. The etiology of injuries was falls and traffic accidents in 87% of cases. The hanging cast group had the most of elbow contractures and insufficient results of functional scales. The plating group had lower average values of scores than nails, especially considering the elbow function. Among subgroups, the locked intramedullary nails had better results than Ender nails. The most complicated cases treated with Ilizarov and Mitkovic's external fixators had good results, especially in the treatment of open humeral shaft fractures; however, the rehabilitation period was longer. The best average functional results were recorded in the nailing group because of rigid fixation, solid callus formation and return to everyday activities in the shortest time.