Recent studies have shown that in patients with closed humeral shaft fracture, surgery fails to provide superior functional outcomes when compared with non-operative patients. However, the need for secondary surgery has been raised among patients treated non-operatively. The objective of this study is to compare the outcomes of patients with closed humeral shaft fractures who were successfully treated in the initial treatment versus those who needed secondary surgery.
This randomized trial included a total of 82 patients with closed, displaced humeral shaft fractures. The patients were randomized in a 1:1 ratio to receive surgery with plate fixation or functional bracing. The primary outcome of the study was the Disabilities of Arm, Shoulder and Hand (DASH) score.
Of 82 randomized patients, 74 completed the two-year follow-up. At two years, the mean DASH score was 6.8 in the initial surgery group, 6.0 in the bracing group, and 17.5 in the secondary surgery group. The difference between initial treatment and secondary groups was –10.5 points, whereas the difference between the bracing group and secondary surgery group was –11.5 points.
The research concluded that of the patients with closed humeral shaft fracture treated with functional bracing, two-thirds of patients might heal after initial treatment while one-third could require secondary surgery.
Ref: https://jamanetwork.com/journals/jamasurgery/article-abstract/2778638?resultClick=1
