{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T00:42:11Z","timestamp":1784335331187,"version":"3.55.0"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","funder":[{"DOI":"10.13039\/100013769","name":"Orthopaedic Trauma Association","doi-asserted-by":"crossref","award":["1000402822"],"award-info":[{"award-number":["1000402822"]}],"id":[{"id":"10.13039\/100013769","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:sec>\n            <jats:title>OBJECTIVES:<\/jats:title>\n            <jats:p>To compare radiographic and clinical outcomes in nonoperative management of humeral shaft fractures treated initially with coaptation splinting (CS) followed by delayed functional bracing (FB) versus treatment with immediate FB.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Design:<\/jats:title>\n            <jats:p>Retrospective cohort study.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Setting:<\/jats:title>\n            <jats:p>Academic Level 1 Trauma Center.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Patient Selection Criteria:<\/jats:title>\n            <jats:p>Patients with closed humeral shaft fractures managed nonoperatively with initial CS followed by delayed FB or with immediate FB from 2016 to 2022. Patients younger than 18 years and\/or with less than 3 months of follow-up were excluded.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Outcome Measures and Comparisons:<\/jats:title>\n            <jats:p>The primary outcome was coronal and sagittal radiographic alignment assessed at the final follow-up. Secondary outcomes included rate of failure of nonoperative management (defined as surgical conversion and\/or fracture nonunion), fracture union, and skin complications secondary to splint\/brace wear.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>Ninety-seven patients were managed nonoperatively with delayed FB (n = 58) or immediate FB (n = 39). Overall, the mean age was 49.9 years (range 18\u201394 years), and 64 (66%) patients were female. The immediate FB group had less smokers (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.003) and lower incidence of radial nerve palsy (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.025), with more proximal third humeral shaft fractures (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.001). There were no other significant differences in demographic or clinical characteristics (<jats:italic toggle=\"yes\">P<\/jats:italic> &gt; 0.05). There were no significant differences in coronal (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.144) or sagittal (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.763) radiographic alignment between the groups. In total, 33 (34.0%) humeral shaft fractures failed nonoperative management, with 11 (28.2%) in the immediate FB group and 22 (37.9%) in the delayed FB group (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.322). There were no significant differences in fracture union (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.074) or skin complications (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.259) between the groups.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>This study demonstrated that nonoperative treatment of humeral shaft fractures with immediate functional bracing did not result in significantly different radiographic or clinical outcomes compared to treatment with CS followed by delayed functional bracing. Future prospective studies assessing patient-reported outcomes will further guide clinical decision making.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>LEVEL OF EVIDENCE:<\/jats:title>\n            <jats:p>Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/bot.0000000000002810","type":"journal-article","created":{"date-parts":[[2024,3,25]],"date-time":"2024-03-25T18:15:51Z","timestamp":1711390551000},"page":"383-389","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Nonoperative Treatment of Humeral Shaft Fractures With Immediate Functional Bracing Versus Coaptation Splinting and Delayed Functional Bracing: A Retrospective Study"],"prefix":"10.1097","volume":"38","author":[{"given":"Maaz","family":"Muhammad","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey A.","family":"Foster","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jarod T.","family":"Griffin","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daria L.","family":"Kinchelow","sequence":"additional","affiliation":[{"name":"Department Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, KY; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos R.","family":"Sierra-Arce","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wyatt G.S.","family":"Southall","sequence":"additional","affiliation":[{"name":"Department Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, KY; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ferras","family":"Albitar","sequence":"additional","affiliation":[{"name":"Department Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, KY; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric S.","family":"Moghadamian","sequence":"additional","affiliation":[{"name":"Department Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, KY; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond D.","family":"Wright","sequence":"additional","affiliation":[{"name":"Department Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, KY; 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