Management of Humeral Fractures in a Resource Poor Region in North-Western Nigeria

Abstract

Background: Humeral fractures can occur alone or as part of associated injuries in polytrauma. We aim to document the pattern and management of these fractures in our sub-region. Patients and Method: This was a retrospective study of all cases of humeral fractures that presented at our outpatient and emergency departments from January 2012 to December 2014. Information obtained includes age, sex, mechanism and pattern of injury, treatment offered and outcome. Level of significance was < 0.05 Results: A total of eighty cases were seen with a M: F ratio of 4.3:1. Thirty-three percent of patients were between 31-40 year and the left humerus was affected in 51.3%. Road traffic accident was the commonest mechanism in 71.3%. Eighty-five percent of cases were closed fractures and diaphyseal fractures constituted 56.3%. Oblique fracture pattern was the commonest in 42.5% followed by transverse in 23.8%. There were associated injuries in 52.5% of cases. Eighty- four per cent of patients presented within 72 hours of injury while 11.3% of patient had prior treatment by Traditional bone setters (TBS). Complications at presentation in those with prior TBS intervention was statistically significant (P=0.005). Treatment offered were cast splintage in 57.5%, open reduction and internal fixation in 17.5%. Amputation was done in 5.0% of cases. Wound sepsis (5.0%), elbow stiffness (2.5%), chronic osteomyelitis (2.5%) were the encountered post intervention complications. Conclusion: Fractures involving the humerus are mainly diaphyseal and cast splintage is the commonest mode of management in our sub-region.