Humerus Brace for Treating Humeral Shaft Fractures: A Retrospective Cohort Study of Union and Failure Rates

Area of Science:

• Orthopedic Surgery
• Traumatology
• Biomechanics

Background:

• Non-operative management of humeral shaft fractures using functional braces is common.
• Modern outcomes and union rates for this approach may differ from historical benchmarks.

Purpose of the Study:

• To evaluate the union rate and success of humeral shaft fractures treated with functional bracing.
• To analyze the influence of fracture level and pattern on treatment outcomes.

Main Methods:

• Retrospective audit of adult patients with closed humeral shaft fractures managed in functional braces (2012-2019).
• Data collected from orthotics records, analyzing demographics, fracture characteristics, complications, and outcomes.
• Failure defined as surgical fixation for malunion/non-union or persistent non-union.

Main Results:

• 88 patients included; 78.4% achieved union, with an overall success rate of 67%.
• 33% of patients failed brace treatment, 25% requiring surgery.
• Proximal and mid-shaft fractures had higher non-union rates than distal fractures.

Conclusions:

• Functional bracing yields a modest union rate for humeral shaft fractures compared to historical data.
• Fracture level, especially proximal and mid-shaft, significantly impacts non-union rates.
• Future research should explore patient compliance, alignment, and brace fit's role in union potential.