ORIGINAL RESEARCH article
Front. Surg.
Sec. Orthopedic Surgery
This article is part of the Research TopicAdvancing Orthopedic Surgery: unique Case Reports driving progressView all 18 articles
Clinical Outcomes of Three Treatment Methods for Humeral Shaft Fractures: A Comparative Study
Provisionally accepted
- 1Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China
- 2Jiangxia District Hospital of Traditional Chinese Medicine,, Wuhan, China
- 3General Hospital of Central Theater Command, Wuhan, China
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Objective: To compare the clinical efficacy of three techniques (nonoperation, external fixation, and open reduction and plate osteosynthesis) for the treatment of diaphyseal fractures of the humerus, thereby providing guidance for the selection of treatment methods. Methods: This retrospective study included 138 patients with humeral shaft fractures treated between January 2021 and December 2024, all with complete followup data. Patients were grouped by treatment: NOT (n=46, managed with splint/plaster/functional bracing), EF (n=28), and ORPO (n=64). Followup was conducted via outpatient visits or telephone and included fracturehealing time and rate, complications, hospital stay, time to return to work, Constant shoulder score, Mayo elbow score, and patient satisfaction. Results: Mean followup durations were 21.4±3.7, 20.1±4.7, and 22.6±5.4 months in the NOT, EF, and ORPO groups, respectively. Union times differed significantly but modestly (P=0.002; ε²=0.079), with union rates ranging from 95.7% to 96.9%. Complication profiles varied (P<0.001; V=0.438): malunion predominated in the NOT group, while radial nerve palsy and infection were more frequent in the EF and ORPO groups, respectively. Hospital stay was shortest in the NOT group (4.0 days), and time to return to work was also reduced compared with the EF and ORPO groups (13.0 vs 16.0 and 14.0 weeks, P<0.05). Functional scores (Constant and Mayo) were comparable across groups (P>0.05). Patient satisfaction was higher in the NOT group, albeit with a small effect size (P<0.05; η²=0.046). Conclusions: Within the limitations of this retrospective, non-randomized study, our findings suggest that all three treatment modalities achieve comparable fracture union rates and functional outcomes in humeral shaft fractures. Meanwhile, these results underscore the value of individualized treatment selection. In appropriately selected patients, NOT remains a viable and cost-effective option. But these findings should be validated in prospective trials.
Keywords: Curative effects, External fixator, Humerus shaft fracture, Nonoperative treatment, open reduction and plate osteosynthesis
Received: 03 Nov 2025; Accepted: 12 Feb 2026.
Copyright: © 2026 Wang, Xie, Liu, Wang and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Wei Wang
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