A prospective randomised control study on dynamic compression plating versus intra medullary interlocking nailing in humeral diaphyseal fractures
Keywords:Humerus fracture, Interlocking intramedullary nail, DCP, ORIF, DASH score
Background: Surgical fixation of humeral shaft fractures generally involves plating or nailing. Despite the extensive literature comparing outcomes after open reduction with internal fixation (ORIF) with plating and interlocking intramedullary nailing (ILIMN) for acute humeral diaphyseal fractures, the superior treatment strategy still remains controversial. The purpose of this study was to compare the functional outcome of each method of fixation (dynamic compression plating and interlocking nailing) for the shaft of humerus fracture and to analyse statistically significant difference in the results of these two methods in terms of functional outcome, rate of healing and complications.
Methods: We conducted a prospective randomized control study and evaluated the results of 50 patients having humeral shaft fracture which were internally fixed with antegrade interlocking nailing (25 patients) and dynamic compression plating (DCP) plate (25 patients). Patients were followed up on average of 11.4 months and their radiological outcomes were assessed with plain radiography and with DASH score.
Results: The plating group had statistically significant faster radiological healing and better DASH score compared to nailing group. Also, postoperative complication rate was higher in ILN group which was statistically significant.
Conclusions: ORIF with DCP provides better results in terms of good functional outcome, faster radiological union and less post-operative complications compared to ILIM nailing. Hence, we concluded that plating is a superior option than nailing.
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