A Pre-fabricated Bracing System for the Management of Humeral Shaft Fractures: Experience of a Centre in the United Kingdom.

BACKGROUND: The aim of our study is to evaluate the ability of a pre- fabricated humeral bracing system in providing sufficient stability to fracture union and carry out a cost analysis comparing bracing versus surgical fixation for these fractures.

MATERIAL AND METHODS: A review of humeral shaft fractures treated with a pre-fabricated humeral bracing system was undertaken.

RESULTS: 20 humeral fractures (20 patients) were included. Mean patient age was 56.8 years (range 16- 89). There were 14 AO type A, 3 type B and 3 type C fractures. Median time interval from fracture to brace application was 8 days (range 0-41). Clinical and radiological union was achieved in 15 humeri (75%). Median time to clinical and radiological union was 80 days (range 32-434). The cost of treating humeral shaft fractures surgically by plating and by humeral bracing was estimated at £ 2292.99 and £ 1228 per case, respectively.

CONCLUSIONS: 1. A pre-fabricated bracing system is an efficacious and cost-effective modality for humeral shaft fracture treatment. 2. It may, however, lead to a high non-union rate as well as shoulder and elbow stiffness. 3. A prospective randomized trial comparing bracing with internal fixation of humeral shaft fractures is needed.