This article is more than 5 years old. Information may no longer be current.
Humerus fractures from civilian gunshot wounds may be treated nonoperatively
Click Here to Manage Email Alerts
Most humerus fractures among a select group of patients who required surgical stabilization following civilian gunshot wounds may be treated nonoperatively, according to this study.
Researchers included 54 patients with humerus shaft fractures sustained from low-velocity gunshot wounds with 29 patients treated nonoperatively, 25 having operative treatment, 14 undergoing plate fixation, six having application of an external fixator, three receiving an intramedullary rod and two having irrigation and debridement with fracture immobilization provided by a brace. Researchers recorded patient demographics and injury data, radiographic analyses and treatment complications, and evaluated healing of soft tissue and bony injuries, including fracture alignment in patients treated nonoperatively.
According to study results, 52 patients of the 54 patients had minor soft tissue damage and were treated successfully with minimal local wound care. Extended wound care with repeated irrigation and debridement was used among two patients with larger wounds. Primary mode of treatment was used among 47 fractures of 54 fractures healed, and seven patients went on to nonunion requiring further intervention. Researchers found the average deformity of patients treated nonoperatively was 16.5° in the coronal plane and 4.4° in the sagittal plane.
“Fracture of the humerus following a civilian gunshot wound is associated with limited soft tissue damage, extensive comminution, and, in the current study, a significant incidence of neurologic or vascular injury. Many patients can be treated nonoperatively with coaptation splints followed by bracing with good results. Neurologic recovery can be expected approximately 70% of the time,” the researchers wrote. “The current authors agree with previous reports and have data from their own experience that the decision to perform surgical stabilization of the fracture involves polytrauma, obesity, associated vascular injury or extensive soft tissue damage, nonunion or inability to comply with splinting and bracing. These patients often do not return for follow-up due to socioeconomic reasons, creating a new set of challenges regarding their care.”
Disclosure: The researchers have no relevant financial disclosures.
Click Here to Manage Email Alerts