Seven month prospective study of patients seen at Kenyatta national hospital with diaphyseal fracture of the humerus

Abstract

This was a prospective study over a period of seven months from February 2004 to August 2004 .The purpose of the study was to determine the pattern of diaphyseal fractures of the humerus in Kenyatta National Hospital .The study assessed the causes, sites and management of these fractures at the hospital. A total of 78 patients were recruited into the study. Eleven patients were unavailable for follow up. Males were more affected in this injury (75.6%) than the females. There was a male to female ratio of 3: 1. The mean age was 34 years with a range of 10 to 66 years. Road traffic accidents were the leading cause of fracture of the shaft of humerus (52.6%). Other causes included falls, assault, gunshot injury, machine injury and pathological fractures. Majority of these fractures involved the middle third of the shaft .Seventy seven of these fractures were initially managed by conservative means including U-slab, back slab and hanging cast. One patient had external fixators inserted.

Plating was the most commonly performed procedure (74%). Kirschner wiring was performed for 11.1% and Rush pin for 14.8%. Iatrogenic radial nerve palsy occurred in one patient (3.7%). Other complications documented during this period were Stiff elbow, stiff/ shoulder and deep infection. Appropriate management and prognosis of radial nerve palsy complicating this fracture remains controversial. Conservative management remains the mainstay of treatment of this fracture. However operative treatment can be carried out successfully when indicated.