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Initial management of humeral shaft fractures with functional splints versus coaptation splints

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

Humerus shaft fractures are commonly acutely immobilized with coaptation splints (CS), which can be difficult to apply and poorly tolerated by the patient. Functional splints (FS), which work on the same principle as functional braces, are an alternative to CS. The purpose of this study was to directly compare CS and FS in terms of application and fracture reduction.

Methods

A retrospective review identified humeral shaft fractures managed nonoperatively with initial immobilization in a FS (n = 19) versus a CS (n = 15). In addition, 13 residents completed a blinded survey on splint application.

Results

The FS and CS groups did not differ in initial fracture angulation and translation on anteroposterior (AP) and lateral radiographs. Post-splint application, there was no clinically relevant difference in fracture angulation/translation between groups, and this persisted at the subsequent follow-up visit. All residents reported that the FS was easier to apply and took less time.

Conclusion

This study results demonstrated the FS results in similar reductions in humeral shaft fractures as CS. A survey of residents found that the FS was easier to apply, took less time, and was better tolerated by patients. Subsequently, we prefer the FS over the CS for the acute management of humeral shaft fractures.

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References

  1. Court-Brown CM, Caesar B (2006) Epidemiology of adult fractures: a review. Injury 37:691–697

    Article  Google Scholar 

  2. Sarmiento A, Kinman PB, Galvin EG et al (1977) Functional bracing of fractures of the shaft of the humerus. J Bone Jt Surg Ser A 59:596–601. https://doi.org/10.2106/00004623-197759050-00004

    Article  CAS  Google Scholar 

  3. Ali E, Griffiths D, Obi N et al (2015) Nonoperative treatment of humeral shaft fractures revisited. J Shoulder Elb Surg 24:210–214. https://doi.org/10.1016/j.jse.2014.05.009

    Article  Google Scholar 

  4. Zafar MS, Porter K (2007) Humeral shaft fractures: a review of literature. Trauma 9:273–282. https://doi.org/10.1177/1460408607088315

    Article  Google Scholar 

  5. Matsunaga FT, Tamaoki MJS, Matsumoto MH et al (2017) Minimally invasive osteosynthesis with a bridge plate versus a functional brace for humeral shaft fractures. J Bone Jt Surg 99:583–592. https://doi.org/10.2106/JBJS.16.00628

    Article  Google Scholar 

  6. Spiguel AR, Steffner RJ (2012) Humeral shaft fractures. Curr Rev Musculoskelet Med 5:177–183. https://doi.org/10.1007/s12178-012-9125-z

    Article  PubMed  PubMed Central  Google Scholar 

  7. Clement ND (2015) Management of humeral shaft fractures; non-operative versus operative. Arch Trauma Res. https://doi.org/10.5812/atr.28013v2

    Article  PubMed  PubMed Central  Google Scholar 

  8. Pal JN, Biswas P, Roy A et al (2015) Outcome of humeral shaft fractures treated by functional cast brace. Indian J Orthop 49:408–417. https://doi.org/10.4103/0019-5413.159619

    Article  PubMed  PubMed Central  Google Scholar 

  9. Meinberg E, Agel J, Roberts C et al (2018) Fracture and dislocation classification compendium—2018. J Orthop Trauma 32:S1–S10. https://doi.org/10.1097/BOT.0000000000001063

    Article  PubMed  Google Scholar 

  10. Koch PP, Gross DFL, Gerber C (2002) The results of functional (sarmiento) bracing of humeral shaft fractures. J Shoulder Elb Surg 11:143–150. https://doi.org/10.1067/mse.2002.121634

    Article  Google Scholar 

  11. Ekholm R, Tidermark J, Törnkvist H et al (2006) Outcome after closed functional treatment of humeral shaft fractures. J Orthop Trauma 20:591–596. https://doi.org/10.1097/01.bot.0000246466.01287.04

    Article  PubMed  Google Scholar 

  12. Serrano R, Mir HR, Sagi HC et al (2020) Modern results of functional bracing of humeral shaft fractures: a multicenter retrospective analysis. J Orthop Trauma 34:206–209. https://doi.org/10.1097/BOT.0000000000001666

    Article  PubMed  Google Scholar 

  13. Rutgers M, Ring D (2006) Treatment of diaphyseal fractures of the humerus using a functional brace. J Orthop Trauma 20:597–601. https://doi.org/10.1097/01.bot.0000249423.48074.82

    Article  PubMed  Google Scholar 

  14. Papasoulis E, Drosos GI, Ververidis AN, Verettas D-A (2010) Functional bracing of humeral shaft fractures. A Rev Clin Stud Inj 41:e21-27. https://doi.org/10.1016/j.injury.2009.05.004

    Article  Google Scholar 

  15. Ricciardi-Pollini PT, Falez F (1985) The treatment of diaphyseal fractures by functional bracing. Results in 36 cases. Ital J Orthop Traumatol 11(2):199–205

    CAS  PubMed  Google Scholar 

  16. Walker M, Palumbo B, Badman B et al (2011) Humeral shaft fractures: a review. J Shoulder Elb Surg 20:833–844

    Article  Google Scholar 

  17. Rangger C, Kathrein A, Klestil T (1999) Immediate application of fracture braces in humeral shaft fractures. J Trauma Inj Infect Crit Care 46:732–735. https://doi.org/10.1097/00005373-199904000-00033

    Article  CAS  Google Scholar 

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Correspondence to Joshua A. Parry.

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Chambers, L.R., Juels, P., Mauffrey, C. et al. Initial management of humeral shaft fractures with functional splints versus coaptation splints. Eur J Orthop Surg Traumatol 31, 1129–1134 (2021). https://doi.org/10.1007/s00590-020-02845-6

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  • DOI: https://doi.org/10.1007/s00590-020-02845-6

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