Shoulder impairment following treatment of diaphysial fractures of humerus by functional brace

Abstract

Introduction: Treatment of humeral shaft fractures by functional bracing has been reported to be effective in achieving high rate of fracture union and good function of the adjacent shoulder and elbow joints. Since our previous clinical impression indicated an occurrence of shoulder function impairment following this treatment, we investigated the shoulder function in a consecutive series of patients treated by functional bracing for fractures of humeral shaft in order to estimate their residual shoulder function.

Materials and methods: We followed 15 consecutive patients with humeral shaft fractures treated by functional brace. The mean follow up was 30 months (range 12-57 months); seven patients with midshaft fracture, four patients with proximal third, and four patients with fractured distal third of the humeral diaphysis. All the patients were evaluated by the Constant score of the injured limb in comparison to the contra-lateral not injured shoulder and by the Oxford shoulder score of the injured limb.

Results: We found that all the fractures were united with mean varus angulation of 13 degrees and with mean angulation in the saggital plane of 9 degrees antecurvatum, Constant scores were significantly lower in the injured shoulders (P < 0.001) and the function of the shoulders in the injured extremities were estimated as having mean Oxford shoulder score of 34 (range 17-54).

Conclusions: The evaluation of the present series revealed an impaired functional outcome in the shoulders after humeral shaft fracture. Our results indicate that although the fracture union is usually achieved following the functional bracing of humeral shaft fractures, the shoulder function in the injured limb may remain impaired.