This article aims to compare the efficacy of open reduction and internal plate fixation with non-surgical functional braces for the treatment of closed humeral shaft fractures.

Prospective collection 82 patients, mean age 48.9 years, 38 women [46%], 44 men [54%], Age (49.0±17.4), who underwent treatment for closed humeral shaft fractures at our hospital from October 2018 to January 2021, were randomly assigned surgical treatment with open reduction and internal plate fixation (n=38) or non-surgical treatment with functional braces (n=44). main results: Disability of Arm Shoulder and Hand (DASH) score at 12 months (range: 0 to 100, with 0 being no disability and 100 being extremely disabled; minimal clinically important difference, 10).

Of the 82 patients randomized, 78 (95%) completed the trial. 13 (30%) patients assigned to a functional brace underwent surgery to promote fracture healing during the 12-month follow-up. At 12 months, the mean DASH score was 8.9 (95% CI, 4.2 to 13.6) in the surgery group and 12.0 (95% CI, 7.7 to 16.4) in the brace group (between-group difference, -3.1 points; 95% CI, -9.6 to 3.3; P=0.341). Nonunion occurred in 11 patients (25%) assigned to a functional brace. 3 patients (8%) who underwent surgery developed transient radial nerve palsy.

In patients with closed humeral shaft fractures, internal fixation did not significantly improve functional outcomes at 12 months compared with nonoperative functional braces.