Key result
Dynamic compression plating improves functional DASH scores by ~18 points versus non-operative treatment.
Why the study?
Many treatment modalities exist for humerus shaft fractures, with conservative treatment as the mainstay, but operative treatment is increasingly used due to advances in anaesthesia and implant design.
Does operative treatment improve functional outcomes compared to non-operative treatment in patients with fracture shaft of humerus?
RCT (n=40)
Random number table
No
Does operative treatment improve functional outcomes compared to non-operative treatment in patients with fracture shaft of humerus?
Absolute Event Rate: 23.4% vs 41.35%
p-value: p=0.007
Operative treatment for humerus shaft fractures yields better functional outcomes than conservative management despite slower union.
Supports operative plating for humerus shaft fractures to optimize function; confirms RCT superiority over non-operative care.
Background: Humerus shaft fractures account for 3% of all orthopaedic injuries. Many modalities of treatment are available. Conservative treatment has been the mainstay of treatment. But now due to improvements in anaesthesia, implant design many patients having fracture shaft of humerus are operated. Methods: We compared the operative and non operative modalities of treatment in this prospective randomised controlled trial. In 40 patients, twenty patients were treated surgically and twenty were treated non surgically between May 2012 to June 2014 in Hindu Rao Hospital, New Delhi. Results: Our results show faster union in non-operative patients but functional DASH scores are significantly better in operated patients. Complications are comparable in both groups. Conclusions: Operative treatment for fracture shaft humerus gives better functional results in this study. Dynamic compression plating of humerus is better method than conservative method and avoids prolonged immobilization. Larger multicentric trials comparing functional cast bracing and plating are needed.
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Kumar et al. (2017) conducted an RCT in Fracture shaft of humerus (n=40). Operative treatment (Dynamic Compression Plating) vs. Non-operative treatment (U slab or hanging cast followed by functional cast) was evaluated on Functional outcome measured by DASH score at 6 months or full recovery (p=0.007). Operative treatment with dynamic compression plating resulted in significantly better functional outcomes (mean DASH score 23.4 vs 41.35, p=0.007) compared to non-operative treatment for humerus shaft fractures.
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