DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20181797

Functional and radiological outcome of comminuted shaft of humerus fracture treated by dynamic compression plate

Bharathi Raja K. V., Ganesh G. Ram

Abstract


Background: Humeral shaft fractures represents between 3% and 5% of all fractures of which a certain number of patients require surgical intervention. This study aims to determine the efficacy of dynamic compression plate in the treatment of humeral shaft fractures.

Methods: A prospective study was carried out over a period of 2 years in Sri Ramachandra Medical College, Chennai including 30 cases of shaft of humerus fractures treated by open reduction and internal fixation using Dynamic Compression plate among which both comminuted and segmental closed shaft of humerus fractures were included. While open fractures and ipsilateral forearm and clavicle fractures were excluded. AO classification was used to classify the fractures and the average follow up period was two years. The American Shoulder and Elbow Surgeons (ASES) shoulder score and Romen al series grading were used.

Results: We had 93.3% excellent/good result and 6.7% poor results. In our series we had one non-union, one delayed union and one case of deep infection.

Conclusions: Proper preoperative planning, minimal soft tissue dissection, strict asepsis, proper postoperative rehabilitation and patient education were essential to obtain excellent results. Early post-operative mobilization following rigid fixation of the fracture of humerus, with DCP lowered the incidence of stiffness and sudecks dystrophy.


Keywords


Humerus shaft, DCP, ASES

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References


Schemitsch EH, Bhandari M. Fractures of the diaphyseal humerus. In: Browner BD, Jupiter JB,Levine AM, Trafton PG, eds. Skeletal trauma, 3rd ed. Toronto: WB Saunders; 2001: 1481-1511.

Brinker MR, O’Connor DP. The incidence of fractures and dislocations referred for Orthopaedic services in a capitated population. J Bone Joint Surg Am. 2004;86:290-7.

Gregory PR. Fractures of the humeral shaft. In: Bucholz RW, Heckman JD, eds. Rockwood and green’s fractures in adults, 5th ed. Philadelphia: Lippincott Williams & Wilkins; 2001: 973-996.

Fears RL, Gleis GE, Selingson D. Diagnosis and treatment of complications: Fractures of the diaphysealhumerus. In: Browner BD, Jupiter JB,Levine AM, Trafton PG, eds. Skeletal trauma, 2nd ed. Toronto: WB Saunders; 1998: 567-578.

Bell MJ, Beauchamp CG, Kellam JK, and McMurtry RY. The results of plating humeral shaft fractures in patients with multiple injuries. J Bone Joint Surg Br.1985;67(2):293-6.

Griend RV, Tomasin J, Ward EF. Open reduction and internal fixation of humeral shaft fractures. J Bone Joint Surg Am. 1986;68:430-3.

Rodriguez-Merchan EC. Compression Plating Versus Hackethal Nailing in Closed Humeral Shaft Fractures Failing Nonoperative Reduction. J Orthop Trauma. 1995;9(3):194-7.

Tingstad EM, Wolinsky PR, Shyr Y, Johnson KD. Effect of immediate weight bearing on plated fractures of humeral shaft. J Trauma. 2000;49(2):278-80.

Klenerman L. Injuries of the arm. In: Wilson FN, editor. Watson-Jones Fractures and Joint Injuries. 6thed, New Delhi: Churchill Livingstone; 1992: 572.