Revisiting the debate on operative vs nonoperative management of humeral shaft fractures

Core Tip

Core Tip: Historically, humeral shaft fractures were predominantly managed through conservative methods. However, with advancements of open reduction internal fixation and intramedullary nailing, the rate of surgical intervention has gradually increased. But according to the previous literature, there were not consistent conclusions about conservative and surgical treatments. While conservative treatment avoids surgical complications and functional bracing has outstanding results, both operative and nonoperative follow-up periods and the potential for complications like nonunion, malunion, and loss of reduction are still debated. Patients in the surgery group benefit from early functional activities, but there is a risk of infection, nonunion, and failure of the internal fixation. Compared with conservative treatment, the surgery group has similar Disabilities of the Arm, Shoulder, and Hand scores at 12 months. Hematopoiesis is further disrupted by disturbed intraoperative soft tissue, and nonunion can result from potential instability in conservative treatment approaches.