CLINICAL EFFECTIVENESS OF FUNCTIONAL BRACING VERSUS SLING IMMOBILIZATION IN THE MANAGEMENT OF HUMERAL SHAFT FRACTURES: A QUASI-EXPERIMENTAL STUDY

Abstract

Background: In most cases, a humeral shaft fracture is treated conservatively with a functional brace or with a sling. There are limited comparisons of both interventions.

Objective: To compare the clinical effectiveness of functional bracing and sling immobilization in patients with humeral shaft fractures.

Methods: A quasi-experimental study was done in 40 patients with humeral shaft fractures from LLRC Lahore and Aziz Fatima Hospital Faisalabad. The study population was split into two groups: Functional Brace Group (FBG, n=20) and Sling Group (SG, n=20). The Disabilities of the Arm, Shoulder and Hand (DASH) score, Numeric Rating Scale (NRS), Constant-Murley Score (CMS) and Mayo Elbow Performance Score (MEPS) were chosen as outcome measures. Baseline and post-treatment (6–8 weeks) assessments were conducted. Wilcoxon Signed-Rank test and Mann-Whitney U test were used for data analysis.

Results: There was a significant difference after treatment between both treatment groups (p < 0.001). Yet the functional brace group had significant improvements with all outcome measures. The mean difference in improvement of the brace group was -47.76 ± 9.67 compared with -35.17 ± 8.52 for the sling group. CMS improvement was 25.90 ± 5.97 versus 18.50 ± 6.05, while MEPS improvement was 58.00 ± 10.81 versus 49.90 ± 9.39 in favor of functional bracing. All of the differences between groups for DASH (p < 0.001), NRS (p = 0.002), CMS (p < 0.001), and MEPS (p = 0.015) were statistically significant.

CONCLUSION: Functional bracing offers: pain relief, performance, function in shoulder and elbow, better than sling immobilization. Conservative treatment with functional bracing is recommended as the best option for the appropriate patient with humeral shaft fracture.