Twenty-one adults who had a fracture of the middle of the humeral shaft
and an injury of the ipsilateral brachial plexus were followed for an
average of twenty-eight months. Only two of these patients showed evidence
of neurological improvement. Of the eleven patients who had an associated
traumatic injury to the brain, eight were treated non-operatively and
three, operatively. The presence of a fracture of the humerus in a flail
extremity has been found to delay rehabilitation markedly and to result in
prolonged hospitalization. Eleven fractures were treated non-operatively
with a brace or cast, and there were five non-unions, two delayed unions,
and two malunions. Of the ten fractures that were treated operatively,
three that were treated by compression-plating all united. Two fractures
were treated by external fixation; one had a delayed union and one, a
malunion. In the remaining five patients, who were treated with an
intramedullary rod, there were two non-unions, one delayed union, and one
malunion.