Functional outcome of modified technique of intramedullary fixation of diaphyseal humeral fractures
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20195798Keywords:
Dynamic compression plating, intramedullary nailing, Diaphyseal humeral fracturesAbstract
Background: The aim of this study was to evaluate the functional outcomes with intramedullary fixation using flexible nails and to follow up for any other complications.
Methods: Study was a prospective study in Lata Mangeshkar Hospital, Nagpur during 2014 to 2016. All the patients enrolled in the study were briefed about the nature of the study. All cases in this series were operated by combined antegrade and retrograde approach.
Results: Total of 30 patients of closed diaphyseal humeral fractures was studied. Maximum i.e., 16 (53.33%) were in the age range of 21-40 years, followed by 10 (33.33%) patients in the range of 41-60 years. 21 (70%) cases had fracture union between 10-16 weeks with a score of 8 points, followed by 8 (26.67%) patients with fracture union duration of less than 10 weeks with a score of 10 points. Only one of the patients landed up with non-union. The mean functional score of patients at 3rd month was 64.03±4.99, 9th month was 73.46±2.56. 86.66% patients had good to fair outcome, 3.33% patient each had excellent and poor outcome.
Conclusions: Comparing results of our study with other studies, we found that our results are almost comparable but not better than open reduction and plating. Complications encountered in our series are comparatively less compared to those encountered during interlock nailing. The trauma to rotator cuff is minimum and this method is good alternative method. Thus, multiple nailing gives better functional outcomes as compared to locked nail.
References
Available at: http://www.who.int/entity/violence_ injury_prevention/publications/road_traffic/world_repo rt/chapter2.pdf. Accessed at: 28 June 2019.
Charnley J. The closed treatment of common fractures. 3rd edition. 1996: 99.
Vishnu M, Kanthimathi B. Short Term Results of Functional Outcome of Plate Osteosynthesis vs Antegrade Intra Medullary Interlocking Nailing In The Treatment of Fractures of Shaft Humerus. Int J Modern Res Rev. 2015;3(10):955-9.
McKee MD, Larsson S. Humeral Shaft Fractures. In: Bucholz RW, Court-Brown CM, Heckman JD, Tornetta P (ed). Rockwood and Green's Fractures in Adults. Philadelphia: Lippincott Williams & Wilkins; 2010.
Beaty JH. Humeral shaft fractures: Orthopaedic Knowledge Update. Rosemont, Ill: American Academy of Orthopaedic Surgeons; 1999: 278-86.
Lal Y, Sharma S, Krishna LG, Ahmed A: Humeral shaft fractures treated by undreamed interlocking nail. Indian J Ortho. 1993;33(3).
Rommens PM, Ver bruggen J, Bross P. Retrograde interlocking nailing of fracture of the humeral shaft – clinical study. Unfallchirurg. 1995;98(3):133-8.
Foster RJ, Dixon GL, Bach AW, Appleyard RW, Green TM. Internal fixation of fractures and nonunion of humeral shaft : Indications and Results in a multi-Center study. J Bone Joint Surg Am. 1985;67(6):857-64.
Tytherleigh-Strong G, Walls N, McQueen MM. The epidemiology of humeral shaft fractures. J Bone Joint Surg Br. 1998;80:249-53.
Mc Cormack RB, Brien D, Buckley RE, Mckee MD. Fixation of fractures of the shaft of humerus by dynamic compression plate or intermedullary nail a prospective randomized trial. J Bone Joint Surg Br. 2000;82A:336-9.
Lin J. Treatment of humeral shaft fractures with the humeral interlocked nail and comparison with plate fixation. J Bone Joint Surg Br. 1998;44A(5):859-64.
Changulani M, Jain UK, Keswani T. Comparison of the use of the humerus intramedullary nail and dynamic compression plate for the management of diaphyseal fractures of the humerus. A randomised controlled study. Int Orthop. Int Orthop. 2007;31(3):391-5.
Chapman JR, Henley MB, Agel J, Benca PJ. Randomized prospective study of humeral shaft fracture fixation: intramedullary nailings versus plates. J Orthop Trauma. 2000;14:162-6.
Kivi MM, Soleymanha M, Haghparast-Ghadim-Limudahi Z. Treatment Outcome of Intramedullary Fixation with a Locked Rigid Nail in Humeral Shaft Fractures. Arch Bone Joint Surg. 2016;4(1):47-51.
Denies E, Nijs S, Sermon A, Broos P. Operative treatment of humeral shaft fractures: comparison of plating and intramedullary nailing. Acta Orthop Belg. 2010;76(6):735-42.
Igbigbi P S, Manda K. Epidemiology of humeral fractures in Malawi. International Orthopaedics (SICOT). 2004;28:338.
Kasturi A, Chokkarapu R. Comparison of Outcomes of Dynamic Compression Plate and Interlocking Intramedullary Nail for Fracture Shaft of Humerus: a Prospective Study. Int J Contemporary Med Res. 2015;1(1):34–7.
Hems TE, Bhullar TP. Interlocking nailing of humeral shaft fractures: Oxford experience 1991 to 1994. Injury. 1996;27(7):485-9.
Flinkkilä, T., Hyvönen, P., Siira, P. et al. Arch Orthop Trauma Surg. 2004;124:537.