CLOSE REDUCTION VERSUS CONSERVATIVE TREATMENT OF CLOSED DIAPHYSEAL FRACTURE: A SINGLE CENTER STUDY

Humeral shaft fractured can be conservatively managed but closed reduction and application of plaster of Paris u-slab have been replaced by humeral brace (Sarmiento) is a method applicable to many types of humeral fractures.

Objective: To determine the outcome of close reduction and conservative management in closed humeral diaphyseal fracture in terms of normal union and delayed union

Study Design: Descriptive case series

Settings: Orthopedic department of Allied and DHQ hospital FSD.

Duration of Study: December 2018 – May 2019

Material & Method: Patients were admitted with 2 weeks old closed humeral shaft fracture and stable humeral shaft fracture. All fractures were immobilized by U-slab of plaster of paris involving acromio-clavicular joint to elbow joint with elbow in 90-degree flexion after reducing fracture by traction and counter traction under GA. Follow up was done for 4 months and outcome in follow up dates were measured for time of union and delayed union.

Results:  170 patients with mean age of 36.68 ± 14.16 were managed conservatively with same technique i.e. U-shaped plaster slab initially then by humeral brace (Sarmiento). Union was achieved in 158 patients (92.94%), 12 patients (7.05%) progress to delayed union. Mean healing time was 10 weeks ± 1.81 with a range of 7 to 15 weeks.

Conclusion: When choosing conservative methods close reduction and conservative management initially with U-slab of plaster of paris later replaced by humeral brace (Sarmiento) is the treatment of choice because of low complication but very high success rates.

Key Words: Humeral shaft fractures, hanging arm cast, coaptation splint or u-slab, functional humeral brace, union, delayed union, fracture, Non-operative