K C Kapil Mani
Tribhuvan University Teaching Hospital, Nepal
Kapil Mani K.C. is currently working in Civil Service Hospital of Nepal, Minbhavan, Kathmandu as an orthopedic surgeon since Second July 2011. He is actively involved to attend the patients in OPD and Emergency department as well as to perform the operations in routine and emergency basis every day. Besides he is involved in teaching and learning activities in the hospital.
Background: Non-operatively treated fractures of the humeral diaphysis have a high rate of union with good functional results. The objective of this study is to find out the outcome of fractures of the humeral diaphysis treated with a functional brace that
permits motion of shoulder and elbow joints and progressive use of the injured extremity.
Materials and Methods: This was a descriptive analytical study in patients of 16 years and above with closed fracture shaft of humerus treated with a functional brace that permits the motion of shoulder and elbow joints. The fracture arms were initially stabilized with U slab or hanging cast for an average of 11 days before application of brace. Radiographs were made at each followup visit until the fracture union occurred. Angulation at fracture site, motion at shoulder and elbow joint were measured at the time of removal of brace.
Results: One hundred and five out of 108 fractures (97.2%) were united with mean duration of 12.16 weeks (Range, 7.5-19.3 weeks). Radial nerve injury was present in 6 cases (5.5%). Various angulation of less than or equal to 15° was present in 90.9% out of 99 patients, while no angulation was present in 6 cases (5.7%) out of 105 patients. Apex anterior angulation of less than or equal to 10° was present in 100% out of 48 patients, whereas apex posterior angulation of less than or equal to 10° was present in 94.1% out of 51 patients.
Conclusion: Functional bracing for the treatment of fractures of the humeral diaphysis is associated with a high rate of union with nearly normal elbow motion and some restriction of shoulder motion.