Effect of Surgery vs Functional Bracing on Functional Outcome Among Patients With Closed Displaced Humeral Shaft Fractures: The FISH Randomized Clinical Trial

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研究概要

Eighty-two patients with closed, displaced humeral shaft fractures were randomized to receive an open reduction and internal plate fixation procedure or functional bracing. The primary outcome of interest was the Disability of the Arm, Shoulder and Hand (DASH) scores at 12 months. Secondary outcomes of interest included pain scores at rest and during activities on a Numeric Rating Scale (NRS), Constant-Murley scores, elbow range of motion, 15D quality of life scores, and patient satisfaction outcomes. Outcomes were assessed up to 12 months post-treatment. Results revealed significantly favourable DASH scores, pain scores during activity, Constant-Murley scores, elbow range of motion, DASH work module scores, and patient satisfaction with shoulder function and upper limb function in the surgery group compared to the bracing group. However at 12 months post-operation, no significant differences in all outcomes were observed between the two groups, with exception of DASH sports module scores which were significantly in favour of the surgery group. At 12 months, a significantly higher proportion of patients in the surgery group were willing to repeat the same treatment compared to the bracing group.