Humeral Shaft Fractures: Retrospective Cohort Comparing Operative Versus Nonoperative Management.

Area of Science:

• Orthopedic surgery
• Traumatology
• Patient-reported outcomes

Background:

• Humeral shaft fractures are common injuries.
• Established treatments include operative fixation and functional bracing.
• Comparative patient-reported outcomes between these methods at one year are debated.

Purpose of the Study:

• To compare 12-month patient-reported function and pain between surgical fixation and functional bracing for humeral shaft fractures.
• To analyze the impact of complications on functional recovery.

Main Methods:

• Retrospective analysis of a prospective cohort of 74 adult patients with AO 12 A2/A3/B2 diaphyseal fractures.
• Patients were treated with either plate fixation (n=36) or functional bracing (n=38).
• Primary outcomes included QuickDASH and Visual Analog Scale (VAS) pain, assessed at baseline and 12 months. ANCOVA was used for adjusted analysis, including a sensitivity model for complications.

Main Results:

• Both groups showed significant improvement in QuickDASH and VAS pain from baseline to 12 months, with no statistically significant difference between surgical fixation and functional bracing.
• Adjusted analysis revealed no significant between-group differences in 12-month QuickDASH or VAS pain.
• Complications occurred in 25.6% of patients; any complication independently worsened 12-month QuickDASH scores (p=0.026).

Conclusions:

• Surgical fixation and functional bracing provide comparable patient-reported function and pain relief at 12 months for humeral shaft fractures.
• Individualized treatment selection is recommended.
• Prevention and management of complications may be more critical for functional recovery than the initial treatment modality.