FRACTURES OF THE HUMERUS

A Comparative Study in Methods of Treatment

¹ Campbell Foundation and the Department of Orthopaedic Surgery, University of Tennessee College of Medicine, Memphis

Undisplaced fractures of the neck of the humerus or impacted fractures in patients of the older age group (over sixty) are best treated by a collar-and-cuff sling and early, active exercise⁵.

Impacted adduction fractures of the neck must be reduced and immobilized in abduction.

As a rule, abduction fractures without avulsion of the greater tubercle may be reduced by manipulation and immobilized in a hanging cast. If the tubercle and rotator cuff are displaced, they must be reduced accurately, usually by surgery.

The treatment of choice for all fractures of the shaft at any level is the hanging cast, provided: (1) that traction is never excessive; (2) that angulation and apposition are controlled; and (3) that the "hanging-cast rules" are observed.

Although fractures of the shaft may be treated successfully by the abduction splint, return of function will be delayed, the apparatus will require continual attention, and the patient will be less comfortable than with the hanging cast.

The shoulder spica is rarely indicated in the treatment of any fracture of the humerus.

Anaesthesia is seldom necessary for reduction of uncomplicated fractures of the neck or shaft, provided that traction is properly utilized. Thus, the necessity for hospitalization is reduced to a minimum.

Since medullary fixation is gaining wide popularity, it is well to re-emphasize the success of conservative treatment of these fractures.

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