Surgical vs. Nonsurgical Management for Humeral Shaft Fractures; Preference Among Orthopaedic Surgeons.

Abstract

BACKGROUND\nDetermining trends in managing humeral shaft fractures may help identify variation in practice which might benefit design of clinical guidance. We aimed to determine the practice of members of the British Elbow and Shoulder Society (BESS) in managing humeral shaft fractures.\n\n\nMETHODS AND MATERIALS\nAn electronic survey was sent to members of BESS. Questions related to preferred surgical and nonsurgical approaches for management of humeral shaft fractures. This was divided into management of proximal, middle and distal third diaphyseal fractures.\n\n\nRESULTS\n91 fully completed responses were analysed. Nonsurgical management was preferred by 90.1% (n=82) for middle-third and 80.2 % (n=73) for proximal third fractures, however 52.7% (n=48) favoured surgical treatment for distal third fractures.\n\n\nCONCLUSIONS\n1. The management preference for humeral shaft fractures amongst surgeons is highly variable. 2. This may be partly attributed to the sparsity of high-quality evidence. 3. Well-designed randomised trials or pro-spective cohort studies may help further guide management of these injuries.