Die konservative Behandlung der Oberarmfraktur

The conservative treatment of humerus diaphyseal fractures ensures excellent late functional results, because the upper extremity is not a weight bearing one, and because the problems due to shape and shortening problems can be compensated with the complex elbow movements and the paracoordination of the shoulder blade. The disadvantages of the immobilisation by plaster (the restriction of the movements of the neighbouring joints) can be prevented by functional conservative treatment. With conservative methods the septic complications, iatrogenic radial nerve injuries, allergic reactions and the further operations-metal removal-can be avoided. Authors between 1992 and 1997 have treated 70% of the humerus diaphyseal fractures with conservative methods. They have controlled 176 cases out of 251 patients with an average 5.6 months follow-up time. The fractures of 174 patients have healed, they have seen 1 pseudoarthrosis, there were 6 method changings (operative treatment) with good and excellent functional results. The operative method is said to be indicated in case of severe soft tissue injuries, open fractures, vessel or nerve injuries, polytraumatized patients, and in cases of primary radial nerve injuries. The gradual raising of the percentage of operative treatment can be done only in connection with the patient's needs, after the correct judgement and consideration of the possible complications.