CONSERVATION VERSUS OPERATIVE TREATMENT OF HUMERUS SHAFT FRACTURE IN ADULTS.
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Keywords
Traumatic fractures of the humerus, non-surgical management, surgical management, functional outcome.
Abstract
Background: Fractures of the Humerus shaft are the frequent injuries in adults and are mostly due to direct trauma or falls. The management of these fractures can be put into two main groups which are non-operative treatment and operative treatment.
Objectives: This research intends to evaluate those two treatment methods in terms of healing time, functional recovery, and complications among one hundred patients managed at Bolan Medical Complex Hospital Quetta in the Department of Orthopedics Surgery.
Study Design: A Retrospective cohort study.
Place and Duration of study: from 05-October 2023 to 05-March 2024 Department of Orthopedics Bolan Medical Complex Hospital Quetta.
Methods: This retrospective cohort study consisted of 100 adult patients with humerus shaft fractures who underwent surgery from 05-October 2023 to 05-March 2024. Patients were divided into two groups: conservative: restricting the movement of the injured part and operative: surgery. The outcomes assessed were time to healing, DASH score for functional recovery, and complications. Statistical analysis was done using the appropriate statistical tests to compare the results.
Results: A total of 100 patients were recruited into the study and of this 60 were managed conservatively while 40 were managed operatively. The healing times were also quicker in the operative group with 85% reaching radiographic union at 12 weeks as opposed to the conservative group where only 65% reached radiographic union at 12 weeks. The mean duration of healing was 9. 5 weeks in operative group and 12. 5 weeks in conservative group. Outcomes related to function were also higher in the operative group with 75% of patients reporting excellent or good DASH scores versus 50% in the conservative group. However, the operative group had a higher rate of complications at 30% compared with 16. 7% in the non-operative group with more infections and hardware failures.
Conclusion: Surgical management of humeral shaft fractures in adults is associated with faster recovery and more favorable long-term outcomes but also with a higher incidence of adverse events. Non-operative management may be a better option for high-risk surgical candidates as they are relatively slow. Collectively these findings can be used in clinical practice to make decisions regarding the treatment of humerus shaft fractures.
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Tauseef Ghaffar Baloch
Post Graduate Student FCPS Orthopedic Surgery Bolan Medical Complex Hospital Quetta. Balochistan .
Muhammad Alamgeer
Resident FCPS Orthopedic Surgery Bolan Medical Complex Hospital Quetta. Balochistan
Mir Behram Khan
Orthopedic Surgeon Shaheed Nawab Ghous Bukhsh Rahesani Teaching Hospital, Mastung. Balochistan
Naseeb Ullah
Post Graduate Resident FCPS Diagnostic Radiology Bolan Medical Complex Hospital Quetta.
Nazir Ahmed
Post Graduate student FCPS orthopedic Surgery Indus Hospital Karachi
Rooman Ul Haq
Research officer Extended Immunization program, Quetta Balochistan