Comparison of 3 Treatments for Fractures of the Humeral Shaft

Authors

Neil Werthmann, HCA HealthcareFollow
Mason Poffenbarger, HCA HealthcareFollow
John Riehl, HCA HealthcareFollow

Files

Division

North Texas

Hospital

Medical City Denton

Specialty

Orthopedic Surgery

Document Type

Presentation

Publication Date

2024

Keywords

fractures, wounds and injuries, therapy

Disciplines

Medicine and Health Sciences | Orthopedics | Surgical Procedures, Operative

Abstract

INTRODUCTION: Over the past 40 years, surgical treatment for humeral shaft fractures has become more common. The purpose of the study was to evaluate complication rates seen with different treatments for humeral shaft fractures. Nerve injury (NI), infection, deep vein thrombosis (DVT), and nonunion (NU) were the specific complications investigated. METHODS: A retrospective database review was performed looking at all patients with humeral shaft fractures. Data was analyzed for complication rates for non-surgical (NS) treatment, open reduction internal fixation (ORIF), and intramedullary nailing (IMN). Inclusion criteria were: 1) patients ages of 18 to 89 and 2) those with humeral shaft fractures. Exclusion criteria were 1) incomplete or incorrect database entry for data points used in the regression analysis, patients with 2) diagnosis of cancer, 3) coagulation disorder, 4) DVT or nerve injury prior to admission/treatment, and 5) pregnancy at the time of fracture. Records were reviewed for presence or absence of complications including infection, DVT, NI, or NU within 2 years of injury. RESULTS: 3,892 patients met study criteria. Patients were more likely to be female (59.48%). 5/531 (0.94%) in the NS group had NI after closed treatment. Patients undergoing IMN developed NI in 3/597 (0.5%), while 47/2,764 (1.7%) developed a NI after undergoing ORIF (p=0.0488). DVT was a rare complication, with a rate of 0.75%. There was no significant difference in the DVT rate among the three groups. NU occurred at a rate of 2%, and did not differ significantly between the three groups. Infection occurred at a rate of 2.39%. The NS group infection rate was 1.13% (6/531). IMN group developed infection in 5/597 (0.84%). ORIF group experienced infection in 82/2,764 (2.97%), (p=0.0010). DISCUSSION AND CONCLUSION: NS treatment, ORIF, and IMN demonstrate similar rates of DVT and NU. ORIF had a higher rate of NI and infection compared to other treatment groups.

Original Publisher

HCA Healthcare Graduate Medical Education

Comments

2nd Place - Research Category

Recommended Citation

Werthmann, Neil; Poffenbarger, Mason; and Riehl, John, "Comparison of 3 Treatments for Fractures of the Humeral Shaft" (2024). North Texas GME Research Forum 2024. 5.
https://scholarlycommons.hcahealthcare.com/northtexas2024/5