[The role of functional bracing in the treatment of humeral shaft fractures].

Objectives: We evaluated clinical, radiographic, and functional results of patients treated with functional bracing for humeral shaft fractures.

Methods: Humeral shaft fractures of 30 patients (19 males, 11 females; mean age 34 years; range 18 to 64 years) were treated with functional bracing. Fractures were on the right in 18 patients, on the left in 12 patients. All were closed fractures, being spiral in 10, comminuted in nine, transverse in six, and oblique in five patients. Humeral fractures were in the upper third, middle third, and distal third in 16, 8, and 6 patients, respectively. Functional brace was applied after a mean of six days (range 0 to 16 days) and was worn throughout day and night until radiographic signs of sufficient union and healing was observed. Functional assessment was made according to the Hunter criteria. The mean follow-up was 20 months (range 10 to 58 months).

Results: Union was achieved in 24 patients (80%) after a mean of 14 weeks (range 11 to 21 weeks). Six fractures (20%) failed to unite and were subsequently treated with surgery. According to the Hunter criteria, 24 patients (80%) were evaluated as good (G3-4), and six patients (20%) as excellent (G5). The mean varus-valgus rotation was 6 degrees , the mean anterior-posterior translation was 8 degrees in patients who had union with functional bracing. Four patients developed skin macerations secondary to brace use. Limb shortening of 1.7 cm occurred in one patient whose fracture was united with bracing.

Conclusion: Our clinical and radiographic results suggest that, based on proper indications, functional bracing applied after regression of edema may be the treatment of choice in humeral shaft fractures.