We are thrilled to announce the publication of our latest research article, titled “Prediction of humeral shaft fracture healing using the Radiographic Union Score for HUmeral Fractures (RUSHU)”, in Bone & Joint Open. This study marks another step forward in improving the prognosis of conservatively treated humeral shaft fractures. As highlighted by findings from the FISH trial, successful conservative treatment generally yields similar functional outcomes compared to surgical intervention. However, about one-third of patients initially managed nonoperatively eventually required secondary surgery, predominantly due to nonunion. These patients experienced poorer functional outcomes on average, lasting up to two years post-trauma, though these differences evened out by the five-year follow-up.
To better identify patients at risk of treatment failure and prolonged functional deficits, it is crucial to have reliable tools for early assessment of conservative management. This is where the RUSHU scoring system can play a vital role, offering a method for evaluating follow-up radiographs and helping to identify patients with an increased radiological risk of nonunion.
Supported by a collaborative team from Helsinki and Tampere University Hospitals, this study focused on validating the RUSHU scoring system’s ability to predict nonunion. By analyzing a cohort of 226 patients, including data from the Finnish Shaft of the Humerus (FISH) trial, the team confirmed the reliability and reproducibility of RUSHU at both six and 12 weeks post-injury. The results identified specific cut-off values (≤ eight at six weeks and ≤ nine points at 12 weeks post-injury) that can help clinicians detect high-risk cases in the treatment process.
While this publication provides valuable insights, we are planning future projects to evaluate fracture stability and its potential to add further diagnostic value in identifying patients at risk of nonunion.
The journey to this publication involved extensive data analysis, numerous consensus meetings, and the collective efforts of clinician-scientists committed to advancing evidence-based orthopaedics. Kudos to all our collaborators for making this study possible!