Table 2.
Reported outcomes of humeral shaft fracture treatments
| First author | Year | Type | Cohort (n) | Union rate (%) | Complication | Functional |
|---|---|---|---|---|---|---|
| Conservative | ||||||
| Ekholm11 | 2006 | retro | 78 | 89.7 | NA | NA |
| Sarmiento14 | 1977 | retro | 51 | 98.0 | 16% > 5° angular deformity | 82% full ROM elbow and shoulder |
| Sarmiento15 | 1990 | retro | 72 (distal third) | 95.8 | 81% varus angulation (without precision), 3% valgus angulation (without precision) 39% posterior angulation from 3–22°, 41% anterior angulation from 1–30°, 36% from 2–15 mm shortening |
45% loss 5–45° ER, 15% loss 10–60°ABD, 13% loss 5–20° F, 24% loss 5–25° elbow extension, 26% loss 5–25° elbow flexion |
| Denard16 | 2010 | retro | 63 | 79.4 | 12.7% malunion (> 20° any plane), 3.2% infection | Elbow ROM 136.25 ± 28.63 (80–180) |
| Sarmiento18 | 2000 | retro | 620 | 97.4 | NA | 8% loss > 10° elbow ROM |
| Rutgers19 | 2006 | retro | 49 | 89.8 | 4% skin breakdown | NA |
| Koch20 | 2002 | retro | 67 | 86.6 | 41.7% deformity > 10° | 4.2% unsatisfactory |
| Ali21 | 2015 | retro | 138 | 83.0 | NA | NA |
| Toivanen22 | 2005 | retro | 93 | 77.4 | NA | NA |
| Neuhaus25 | 2014 | retro | 79 | 80.0 | NA | NA |
| Pollock26 | 2020 | retro | 31 | 68.0 | NA | NA |
| Intramedullary nailing | ||||||
| Dimakopoulos55 | 2005 | retro | 29 | 100.0 | 3% extension of fracture line into the distal metaphysis | Average constant score 16 w FU 96, average Mayo Elbow Score 95.8/100 |
| Park56 | 2008 | pro | 34 | 94.0 | 6% proximal protrusions | Mean ROM at final FU: elevation 144 ± 23.4, ER 66 ± 18, IR 17 ± 4, Neer’s score 91 ± 10, ASES score 84.5 ± 12.4, Costant score 84 ± 14 |
| Rommens57 | 2008 | retro | 99 | 97.0 | 3% secondary RNP, 2% insertion point fracture, 1% implant malposition |
N = 92 Constant score: 91.3% excellent, 5.4% good, 2.2% fair, 1.1% poor Mayo Elbow Score: 81.5% excellent, 14.1% good, 2.2% fair, 2.2% poor |
| Putti38 | 2009 | pro | 16 | 100.0 | 6% proximal impingement, 12.5% iatrogenic fracture, 12.5% secondary RNP, 18.75% adhesive capsulitis | Mean ASES score 45.2 |
| Singisetti39 | 2010 | pro | 20 | 95.0 | 5% deep infection | Rodriguez-Merchan criteria: 20% excellent, 45% good, 25% fair, 10% poor |
| Changulani40 | 2007 | pro | 21 | 85.7 | 4.7% deep infection, 33.3% 1.5–4.0 cm shortening, 4.7% axillary nerve injury | Mean ASES score 44 |
| Benegas41 | 2014 | pro | 19 | 94.7 | 5.2% superficial infection | Mean UCLA score 31.2 points Mean Broberg-Morrey score 94.8 points |
| McCormac42 | 2000 | pro | 19 | 89.0 | 15% secondary RNP, 5% late fracture, 10% intraoperative comminution, 5% infection, 15% impingement, 5% adhesive capsulitis (shoulder) | Mean ASES score 47 points |
| Chapman43 | 2000 | pro | 38 | 95.0 | 2.6% malunion (> 10° any plane), 5% secondary RNP, 10% hardware removal | 16% decreased shoulder ROM (> 10° compared with contralateral side) |
| Plate | ||||||
| Denard16 | 2010 | retro | 150 | 91.3 | 1.3% malunion (> 20° any plane), 4.7% infection | 130.12 ± 17.01 (25–150) |
| Putti38 | 2009 | pro | 18 | 94.0 | 6% adhesive capsulitis | Mean ASES score 45.1 |
| Singisetti39 | 2010 | pro | 16 | 94.0 | 6.25% secondary RNP, 6.5% deep infection | Rodriguez-Merchan criteria: 25% excellent, 68.75% good, 0% fair, 6.25% poor |
| Changulani40 | 2007 | pro | 24 | 87.5 | 12.5% deep infection, 4.1% arm shortening (without precision), 4.1% secondary RNP | Mean ASES score 45 |
| Benegas41 | 2014 | pro | 21 | 100.0 | 4.7% deep infection | Mean UCLA score 31.4 points, Mean Broberg-Morrey score 94.1 points |
| McCormac42 | 2000 | pro | 22 | 95.0 | 4.5% intraoperative comminution, 4.5% minimal loss of fixation | Mean ASES score 48 points |
| Chapman43 | 2000 | pro | 46 | 93.0 | 4% malunion (> 10° any plane), 6.5% deep infection, 2% secondary RNP, 2% hardware removal | 8.6% decreased elbow ROM (> 10° compared with contralateral side) |