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 groups: the 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 internal fixation either by plating or by nailing in the operative group. The follow-up parameters included: fracture 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 für Osteosynthesefragen (AO) classification between the non-operative group and the operative group. The fracture healing rate: the non-operative group: 96.1%(72/76)， the operative group: 97.7%(172/176), P=0.46; the fracture union time: the non-operative group: (10.24±2.93) weeks, the operative group: (10.69±2.51) weeks, P=0.22; the complication rate: the non-operative group: 5.3%（4/76），the operative group: 15.3%（27/176）， P=0.03. The complications included: nonunion: the nonoperative group: 3.95%（3/76）， the operative group: 2.3%（4/176）, P=0.434; radial nerve palsies: the non-operative group: 0%（0/76）， the operative group: 5.7%（10/176）, P=0.035; bone split: the non-operative group: 0%（0/76）， the operative group: 1.7%（3/176）, P=0.556; elbow stiffness: the nonoperative group:1.3%（1/76）， the operative group: 0.6%（1/176）, P=1.000; shoulder pain: the nonoperative group:0%（0/76）， the operative group: 5.1%（9/176）, P=0.061. The ConstantMurley shoulder score: the non-operative group: 97.37±4.94, the operative group: 96.34±6.88, P=0.244. The Mayo elbow score: the non-operative group: 99.80±1.72, the operative group: 99.49±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.

Key words: Humeral shaft fracture, Plaster, Small splint, Plate, Interlocking intramedullary nail