Comparison of the Results of Treatment of Humeral Shaft Fractures

Approximately 1-3% of all human fractures and 5-10% of all long bone fractures occur in the humeral shaft [1,2]. They account for about 20% of all humeral fractures [1]. The humeral shaft is situated between the superior margin of pectoralis major tendon insertion to supracondylar ridges. The incidence of those fractures in population is 14-20/100 000 per year [1]. Their importance is great because fractures complicated with nonunion and inadequate bone union lead to disability of patients, prolonged absence from work and higher hospital expenses. Fractures with associated injuries of major blood vessels of brachial region and infection can be life threatening. Humeral shaft fractures are most frequently treated by non-operative means [3] (functional brace or hanging cast), rarely by thoracobrachial immobilization and bone traction. However, the range of indications for operative methods of those fractures have been widened in the last two decades in order to achieve adequate function in the shortest possible time after the injury, better quality of life and decreased period of treating [2, 5]. Improved methods of intramedullary fixation, osteosynthesis with plates and screws and external fixators have contributed to the higher frequency of surgical treatment of these injuries [2,4,5]. Dilemmas regarding humeral shaft management are associated with the absence of universally accepted indications for operations [4] and choice of operative technique. The published results are very controversial and every method has its advantages and weaknesses. Since a wide choice of treating possibilities, operative methods and implants is offered to manage these fractures, but without the absolute agreement of authors, the aim of this study was to compare the functional results of non-operative and different operative techniques of humeral shaft fracture management.