The external fixation in the treatment of humeral diaphyseal fractures: Outcomes of 84 cases

We retrospectively review 84 cases of diaphyseal humeral fractures (24 type A, 38 type B, 22 type C of the AO/OTA classification) treated with external fixation (Hoffmann II frame) between 1995 and 2007. Six of these fractures were complicated with radial nerve palsy. Four cases were open fractures. All reductions were achieved closely or through minimal open approaches. All fractures achieved consolidation with an average of 95 days (range 58-140). The six radial nerve palsies had complete spontaneous recovery. According to the Constant score excellent shoulder function was recorded in 54.6% of the cases, good results in 25%, fair in 13.6% and poor in 6.8%. The elbow function according to the Mayo elbow performance index was excellent in 81.8% of cases, good in 13.6%, fair in 2.3%, and poor in 2.3%. We observed superficial pin tract infections in 12% of the patients. There was no cases of deep infection. External fixation of humeral diaphyseal fractures as recorded in this case series, represents a management option, which allows straightforward fracture reduction and adequate stability, with a short operative time, excellent consolidation rate and good functional results with no major complications secondary to this type of surgery. (C) 2010 Elsevier Ltd. All rights reserved.