To Operate or Not to Operate (on Humeral Shaft Fractures): That Is the Question

Humeral shaft fractures often are managed nonoperatively with bracing, but concerns about nonunion have pushed decision making toward operative fixation. Investigators in Scotland compared the outcomes of surgery and bracing by randomizing 70 patients (mean age, 49; age range, 18–81) with isolated, closed humeral shaft fractures to open reduction and plate fixation or to functional bracing. Patients were assessed repeatedly during 1 year of follow-up with a range of validated instruments that measured physical function and patient-oriented outcomes.

Several outcomes — including physical function, health-related quality of life, patient satisfaction, range of motion, and pain — were significantly better with surgery when assessed at various t…