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Department of Traumatology, University Hospital Groningen, The Netherlands.
The results of treatment in 237 patients with humeral shaft fractures in relation to the severity of associated injuries were reviewed. Three groups were defined with the Injury Severity Score: multiply injured (ISS greater than or equal to 18; n 58), moderately injured (4 less than ISS less than 18; n 52), and singly injured patients (ISS = 4; n 127). Three basic forms of therapy were evaluated: operative stabilization, traction, and bracing. In singly injured patients the best results were obtained by bracing, and no cases of delayed union were observed. In multiply injured patients, the incidence of delayed union was low after operative stabilization. In moderately injured patients who had to remain in bed, traction therapy was warranted. The majority of 21 primary and 19 secondary radial nerve injuries showed good recovery, independent of surgical exploration.
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