A prospective study of the functional outcome of 3 stitch technique in a compound humerus shaft fracture

Authors

  • Sachin Kale Department of Orthopaedics, Dr. D.Y. Patil Medical College and Hospital, Nerul, Navi Mumbai, Maharashtra, India
  • Raju Patil Department of Orthopaedics, Dr. D.Y. Patil Medical College and Hospital, Nerul, Navi Mumbai, Maharashtra, India
  • Suraj S. Doshi Department of Orthopaedics, Dr. D.Y. Patil Medical College and Hospital, Nerul, Navi Mumbai, Maharashtra, India
  • Joydeep Kumar Dey Department of Orthopaedics, Dr. D.Y. Patil Medical College and Hospital, Nerul, Navi Mumbai, Maharashtra, India
  • Shashwat Anand Department of Orthopaedics, Dr. D.Y. Patil Medical College and Hospital, Nerul, Navi Mumbai, Maharashtra, India
  • Ravi Rajan Modi Department of Orthopaedics, Dr. D.Y. Patil Medical College and Hospital, Nerul, Navi Mumbai, Maharashtra, India
  • Sonali Das Department of Orthopaedics, Dr. D.Y. Patil Medical College and Hospital, Nerul, Navi Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20230290

Keywords:

Antegrade humerus nailing, Three stitch technique, MEPI score

Abstract

Background: Intramedullary nailing of compound shaft humerus fractures has been an innovative and surgically friendly technique to deal with extensive soft tissue injury that impedes open reduction and internal fixation. The purpose of this article is to highlight the minimally invasive technique of intramedullary humerus nailing to prevent the perioperative and postoperative complications encountered. A 1 year follow up of all the patients have shown functionally excellent results and good surgical outcome.

Methods: We have conducted this prospective study from Jan 2020 to Jan 2022 at DR. D.Y. Patil medical college and hospital. Informed consent from each patient was taken explaining the methods of study and probable complications.  By this 3-stitch technique we have treated 25 adult patients sustaining post traumatic compound humerus shaft fractures by Antegrade humerus nailing. We have included compound injury upto type 3A (Gustilo-Anderson classification).

Results: Out of the 25 patients, 23 patients showed functionally excellent outcomes with good compliance to rehabilitation protocol but 2 patients had delayed wound healing of which 1 patient had undergone VAC therapy, which later healed well after a period of 2-3 weeks with sequential dry dressings. None have gone into nonunion.

Conclusions: Our study suggests that the 3-stitch technique is a good alternative method compared to external fixators and other various surgical techniques and yields good results with lesser complications and better cosmetic outcomes in compound injuries.

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References

Rose SH, Melton LJ, Morrey BF, Ilstrup DM, Riggs BL. Epidemiological features of humeral fractures. Clin Orthop. 1982;168:24-30.

Sarmiento A, Waddellle JP, Latta LL. Diaphyseal humeral fractures: treatment options. Instr Course Lect. 2002;51:257-69.

Zuckerman JD, Koval KJ. Fractures of the shaft of the humerus. Chap 15, In Rockwood and Green Fractures in Adults. 4th ed. Philadelphia, PA: JB Lippincott. 1996;1025-51.

Farragos AF, Schemitsch EH, McKee MD. Complications of intramedullary nailing for fractures of the humeral shaft: a review. J Orthop Trauma. 1999;13:258-67.

Lögters TT, Wild M, Windolf J, Linhart W. Axillary nerve palsy after retrograde humeral nailing: clinical confirmation of an anatomical fear. Arch Orthop Trauma Surg. 2008;128:1431-5.

Cheng HR, Lin J. Prospective randomized comparative study of antegrade and retrograde locked nailing for middle humeral shaft fracture. J Trauma. 2008;65:94-102.

Sarmiento A, Kinman P, Galvin E. Functional bracing of fractures of the shaft of the humerus. JBJS (Am). 1977;59:596-601.

Cheng HR, Lin J. Prospective randomized comparative study of antegrade and retrograde locked nailing for middle humeral shaft fracture. J Trauma. 2008;65:94-102.

McCormack RG, Brien D, Buckley RE, McKee MD, Powell J, Schemitsch EH. Fixation of fractures of the shaft of the humerus by dynamic compression plate or intramedullary nail. A prospective randomised trial. JBJS (Br). 2000;82:336-9.

Stern PJ, Mattingly DA, Pomeroy DL, Zenni EJ Jr, Kreig JK. Intramedullary fixation of humeral shaft fractures. J Bone Joint Surg Am. 1984;66:639-46.

Evans PD, Conboy VB, Evans EJ. The Seidel humeral locking nail: an anatomical study of the complications from locking screws. Injury. 1993;24:175-6.

Garnavos C. Intramedullary nailing for humeral shaft fractures: the misunderstood poor relative. Curr Orthop. 2001;15:68-75.

Kolonja A, Vecsei N, Mousani M, Marlovits S, Machold W, Vecsei V. Radial nerve injury after anterograde and retrograde locked intramedullary nailing of humerus. A clinical and anatomical study. Osteo Trauma Care. 2002;10:192-6.

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Published

2023-02-03

How to Cite

Sachin Kale, Raju Patil, Suraj S. Doshi, Dey, J. K., Shashwat Anand, Ravi Rajan Modi, & Sonali Das. (2023). A prospective study of the functional outcome of 3 stitch technique in a compound humerus shaft fracture. International Journal of Research in Orthopaedics, 9(2), 390–395. https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20230290

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Original Research Articles