Management of closed shaft of humerus fractures in non admitted adult patients in a tertiary care hospital
Keywords:Humeral shaft fractures, Conservative treatment, Tertiary care hospital, Adult patients
Background: Fracture shaft humerus is among the most common of fractures. Proximal fractures are more common in elderly and are commonly attributed to low-energy falls, they make up to 5% of all fractures and 25% of humerus fractures, middle fractures about 60% and distal fractures contribute to the remaining fractures. Fractures shaft of humerus account for approximately 3% of all fractures encountered by the orthopedic surgeons.
Methods: From November 2017 to October 2018 sixty-two fractures of humeral shaft presented at Emergency Orthopedic Department in Government Medical College Jammu, 30 fractures considered suitable for the study. All these patients were treated conservatively by using the Coaptation ‘U’ shaped slab discharged the next day and evaluation done both clinically and radiologically every two weeks.
Results: This study showed that the angulation deformities were considerably reduced by the use of U slab and the POP cast. Smoking appeared to have negative effect on the rate of union.
Conclusions: Conservative treatment is one of the most effective methods of treatment. Operative treatment should be limited as much as possible to specific indications given below.
Christensen S. Humeral shaft fractures: Operative and conservative treatment. Acta Chir. Scand. 1967;133:455-60.
Chapman MW. Fractures and dislocations of the Shoulder Girdle and Humerus. In: Chapman’s Orthopedic Surgery. JB Lippincott, Philadelphia. 2003;13:1004-12.
Lefevre-Colau MM, Babinet A, Fayad F, Fermanian J, Anract P, Roren A, et al. Immediate mobilization compared with conventional immobilization for the impacted nonoperatively treated proximal humeral fracture. A randomized controlled trail. J Bone Joint Surg Am. 2007;89:2582-90.
Epps CH Jr, Grant RE. Fractures of the Shaft of the Humerus. In: Rockwood and Green's Fractures in Adults. JB Lippincott, Philadelphia.1991;8:843-69.
Ward EF, Savoie FH, Hughes JL. Fractures of the Diaphyseal Humerus. In: Skeletal Trauma, Browner, B.D., J.B. Jupiter, A.M. Levine and P.G. Trafton (Eds.). WB Saunders, Philadelphia. 1992;9:1177-200.
Hunter SG. The closed treatment of fractures of the humeral shaft. Clin Orthop. 1982;164:192-8.
Winfield J, Miller H, AD L. Evaluation of the “hanging cast” as a method of treating fractures of the humerus. Am J Surg. 1942;55:228–49.
Zagorski JB, Latta LL, Zych GA, Finnieston AR. Diaphyseal fractures of the humerus:treatment with prefabricated braces. J Bone Joint Surg Am. 1988;70:607-10.
Balfour GW, Mooney V, Ashby ME. Diaphyseal fractures of the humerus treated with a ready-made fracture brace. J Bone Joint Surg. 1982;64:11-3.
Kenermann, L. Fractures of the humeral shaft. J Bone Joint Surg. 1966;48:105-11.
Heim, D., F. Herkert and P. Hess. Surgical treatment of humeral shaft fractures-the Basel experience. J Trauma. 1993;35:226-32.
Stern PJ, Mattingly DA, Pomery DL, Zenni EJ Jr, Kreig JK. Intramedullary fixation of humeral shaft fractures. J Bone Joint Surg. 1984;66:639-46.
Jerjes W. Poster #165. Presented at: Orthopaedic Trauma Association Annual Meeting; 2014: 16-18.