Email Alert | RSS

Journal of Peking University(Health Sciences) ›› 2017, Vol. 49 ›› Issue (5): 851-854. doi: 10.3969/j.issn.1671-167X.2017.05.019

• Article • Previous Articles     Next Articles

Comparative results of non-operative and operative treatment of humeral shaft fractures

ZHANG Bo-song1, LI Wen-yi2, LIU Xing-hua1, WEI Jie1, HE Liang1, WANG Man-yi1   

  1. 1. Department of Orthopaedic Trauma, Beijing Jishuitan Hospital, Beijing 100035, China;
    2. Department of Orthopaedics, Hebei General Hospital, Shijiazhuang 050051, China
  • Received:2015-10-22 Online:2017-10-18 Published:2017-10-18

RICH HTML

0   

PDF (PC)

326

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

CLC Number: 

  • R683.41
[1] Zuckerman JD, Koval KJ. Fractures of the shaft of the humerus[M]//Rockwood CA, Green DP, Bucholz RW. Fractures in adults. 4th ed. Philadelphia-New York: Lippincott-Raven, 1996: 1025-1053.
[2] Stewart MJ, Hundley JM. Fractures of the humerus: A comparative study in methods of treatment[J]. J Bone Joint Surg Am,1955, 37(4): 681-692.
[3] Hunter SG. The closed treatment of fractures of the humeral shaft[J]. Clin Orthop Relat Res, 1982(164): 192-198.
[4] Sarmiento A, Zagorski JB, Zych GA, et al. Functional bracing for the treatment of fractures of the humeral diaphysis[J]. J Bone Joint Surg Am, 2000, 82(4): 478-486.
[5] Zagorski JB, Latta LL, Zych GA, et al. Diaphyseal fractures of the humerus: treatment with prefabricated braces[J]. J Bone Joint Surg Am, 1988, 70(4): 607-610.
[6] Koch PP, Gross DF, Gerber C. The results of functional (Sarmiento) bracing of humeral shaft fractures[J]. J Shoulder Elbow Surg, 2002, 11(2): 143-150.
[7] Niall DM, O'Mahony J, McElwain JP. Plating of humeral shaft fractures: has the pendulum swung back? [J]. Injury, 2004, 35(6): 580-586.
[8] Martinez AA, Malillos M, Cuenca J, et al. Marchetti nailing of closed fresh humeral shaft fractures[J]. Chir Main,2004, 23(5): 237-242.
[9] Fernandez FF, Matschke S, Hülsenbeck A, et al. Five years’ cli-nical experience with the unreamed humeral nail in the treatment of humeral shaft fractures[J].Injury, 2004, 35(3): 264-271.
[10] Rommens PM, Blum J, Runkel M. Retrograde nailing of humeral shaft fractures[J]. Clin Orthop Relat Res, 1998(350): 26-39.
[11] Crates J, Whittle AP. Antegrade interlocking nailing of acute humeral shaft fractures[J]. Clin Orthop Relat Res, 1998(350): 40-50.
[12] Klestil T, Rangger C, Kathrein A, et al. The conservative and surgical therapy of traumatic humeral shaft fractures[J]. Chirurg, 1997, 68(11): 1132-1136.
[13] Wallny T, Sagebiel C, Westerman K, et al. Comparative results of bracing and interlocking nailing in the treatment of humeral shaft fractures[J]. Int Orthop, 1997, 21(6): 374-379.
[14] Jawa A, McCarty P, Doornberg J, et al. Extra-articular distal-third diaphyseal fractures of the humerus[J]. J Bone Joint Surg Am, 2006, 88(11): 2343-2347.
[1] XIAO Ruo-tao,LIU Cheng,XU Chu-xiao,HE Wei,MA Lu-lin. Prognostic value of preoperative platelet parameters in locally advanced renal cell carcinoma [J]. Journal of Peking University (Health Sciences), 2021, 53(4): 647-652.
[2] HU Di,ZHANG Miao,KANG Hui-ying,PENG Yun. Investigation and validation of magnetic resonance white matter atlas for 0 to 2 years old infants [J]. Journal of Peking University (Health Sciences), 2021, 53(2): 341-347.
[3] Teng-fei LIU,Tao LIN,Li-hui REN,Guang-ping LI,Jian-jun PENG. Association of CMTM5 gene expression with the risk of in-stent restenosis in patients with coronary artery disease after drug-eluting stent implantation and the effects and mechanisms of CMTM5 on human vascular endothelial cells [J]. Journal of Peking University (Health Sciences), 2020, 52(5): 856-862.
[4] Hong-yu GAO,Jing-ling XU,Huan-xin MENG,Lu HE,Jian-xia HOU. Effect of initial periodontal therapy on blood parameters related to erythrocyte and platelet in patients with type 2 diabetes mellitus and chronic periodontitis [J]. Journal of Peking University (Health Sciences), 2020, 52(4): 750-754.
[5] Bing-chuan LIU,Zhong-wei YANG,Fang ZHOU,Hong-quan JI,Zhi-shan ZHANG,Yan GUO,Yun TIAN. Application of the modified internal fixation method of minimally invasive percuta-neous plate osteosynthesis in treatment of proximal humeral fracture [J]. Journal of Peking University(Health Sciences), 2019, 51(2): 277-282.
[6] LU Jin-hui, QIAN Jun, LIU He, ZHU Jun-xia. Clinical study on autologus platelet-rich fibrin aided revascularization of immature permanent teeth [J]. Journal of Peking University(Health Sciences), 2018, 50(4): 672-679.
[7] FENG Yong-liang, FAN Jing-hui, LIN Xian-juan, YANG Ji-chun, CUI Qing-hua, TANG Xin-jing, XU Guo-heng, GENG Bin. Facilitating the measurement of circulatory hydrogen sulfide with fluorescence probe-coated microplates [J]. Journal of Peking University(Health Sciences), 2017, 49(6): 1060-1065.
[8] LIU Zhong-di, MA Ming-tai, CHEN Jian-hai, FU Zhong-guo, JIANG Bao-guo. “Time-angle measurement” reduction evaluation technique and clinical evaluation of proximal humerus fracture [J]. Journal of Peking University(Health Sciences), 2017, 49(6): 1003-1007.
[9] LI Xu, LI Feng-long, LU Yi, ZHU Yi-ming, GUO Si-yi, LI Yi-jun, JIANG Chun-yan. Clinical study on locking plate for the treatment of non-osteoporotic complex proximal humeral fractures [J]. Journal of Peking University(Health Sciences), 2017, 49(5): 855-860.
[10] WANG Sheng-lin, YANG Zhong-wei, YAN ming, LIU Zhong-jun. Atlantoaxial reduction and fixation guided by the intraoperative CT [J]. Journal of Peking University(Health Sciences), 2017, 49(3): 512-517.
[11] FENG Xue-ru, LIU Mei-lin, LIU Fang, FAN Yan， TIAN Qing-ping. Dose-response of aspirin on platelet function in very elderly patients [J]. Journal of Peking University(Health Sciences), 2016, 48(5): 835-840.
[12] LIU Teng-fei, ZHANG Jing-wei, CHEN Xia-huan, FENG Xue-ru, BAI Zhong-sheng, LIU Mei-lin. Correlation between the level of the urinary 11-dehydrothromboxane B2 and the clinical efficacy of aspirin in patients with type 2 diabete and coronary artery disease [J]. Journal of Peking University(Health Sciences), 2015, 47(6): 920-924.
[13] LIU Teng-fei, ZHANG Jing-wei, CHEN Xia-huan, FENG Xue-ru, BAI Zhong-sheng, LIU Mei-lin. Association between CMTM5 gene rs723840 single nucleotide polymorphism and high on asprin platelet reactivity [J]. Journal of Peking University(Health Sciences), 2015, 47(6): 905-909.
[14] XIA Jing-Gang, QU Yang, HU Shao-Dong, XU Ji, YIN Chun-Lin, XU Dong. Midterm follow-up outcomes of ticagrelor on acute ST segment elevation myocardial infarction undergoing emergency percutaneous coronary intervention [J]. Journal of Peking University(Health Sciences), 2015, 47(3): 494-498.
[15] JIA Long, WANG Tian-Bing- , ZHOU Jing- , HUANG Wei- , LU Hao- , JIANG Bao-Guo. Evaluation of the use of structure screw in PHILOS plate for treatment of proximal humerus fracture in Chinese [J]. Journal of Peking University(Health Sciences), 2015, 47(2): 269-271.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
[1] Author. English Title Test[J]. Journal of Peking University(Health Sciences), 2010, 42(1): 1 -10 .
[2] . [J]. Journal of Peking University(Health Sciences), 2009, 41(2): 188 -191 .
[3] . [J]. Journal of Peking University(Health Sciences), 2009, 41(3): 376 -379 .
[4] . [J]. Journal of Peking University(Health Sciences), 2009, 41(4): 459 -462 .
[5] . [J]. Journal of Peking University(Health Sciences), 2007, 39(3): 319 -322 .
[6] . [J]. Journal of Peking University(Health Sciences), 2007, 39(3): 333 -336 .
[7] . [J]. Journal of Peking University(Health Sciences), 2007, 39(3): 337 -340 .
[8] . [J]. Journal of Peking University(Health Sciences), 2007, 39(3): 225 -328 .
[9] . [J]. Journal of Peking University(Health Sciences), 2007, 39(4): 346 -350 .
[10] . [J]. Journal of Peking University(Health Sciences), 2007, 39(4): 369 -373 .
Copyright © Journal of Peking University (Health Sciences), All Rights Reserved.
Powered by Beijing Magtech Co. Ltd