This article is more than 5 years old. Information may no longer be current.
Fracture gap increases risk of humeral shaft fracture instability
A larger gap between fracture fragments, smoking and female sex were risk factors for fracture instability 6 weeks after functional bracing of patients with mid-diaphyseal humeral shaft fractures.
“The magnitude of the gap between the fracture fragments is an independent risk factor for fracture instability and the lack of a bridging callus 6 weeks after a diaphyseal humeral fracture,” the authors wrote in the abstract.
The researchers retrospectively reviewed 33 females and 46 males with acute, closed, AO type A2 or A3 mid-diaphyseal humeral shaft fractures who were treated between June 2004 and August 2011. Patients were all older than 18 years old and mean follow-up was 10 months.
The researchers found each millimeter of gap between fracture fragments, smoking and female sex were risk factors for fracture instability 6 weeks after functional bracing for diaphyseal humeral shaft fractures. Smoking increased closed treatment failure risk by 40%, smoking six times and female gender 5 times.
Overall, 80% of patients had fracture healing, 20% had motion at the fracture site and a lack of bridging callus on radiograph 6 weeks following surgery.
“Patients should stop smoking to increase the chance of healing,” the authors wrote. “The results of surgery for delayed union or for nonunion of a diaphyseal fracture of the humerus are comparable with those of surgery performed immediately after the injury, so our preferred strategy is to recommend placement of a functional brace initially and to then offer surgery if the fracture remains mobile 6 weeks later.” — by Renee Blisard Buddle
Disclosure: The authors have no relevant financial relationships.