Comparative study to assess the outcome of surgical management of humerus shaft fracture: anterior bridge plating versus humerus intramedullary nailing
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20252646Keywords:
Humerus intramedullary nailing, MIPPO, Humerus shaft fracture, Anterior bridge humerus platingAbstract
Background: Aims and objectives of the study were to assess the outcomes of surgical management of humeral shaft fractures using anterior bridge plating (ABP) versus humeral intramedullary nailing (HIN) in terms of functional recovery and complication rates.
Methods: A prospective observational and interventional study was conducted from July 2022 to June 2024 at the tertiary care hospital. Sample size of 40 patients was taken.
Results: The study included 40 patients, with similar demographics between the groups. We divided the cases in two groups (HIN group A and ABP group B). Out of 40 patients, 23 were male and 17 were female. Postoperative follow-up at 24 weeks indicated improved functional outcomes assessed by UCLA score system for the ABP group B, with 65% achieving excellent, 25% good, 10% fair and 0% poor as compared to 55% good, 30% fair, and 15% poor in the HIN group A. In terms of complication, in the group A, one (5%) patient had radial nerve palsy, 3 (15%) nonunion, 1 (5%) delayed union and 1 (5%) superficial infection whereas in group B, no radial nerve palsy and nonunion, but 3 (15%) patients have delayed union and 1 (5%) superficial infection.
Conclusions: Anterior bridge plating demonstrated superior functional recovery compared to intramedullary nailing in patients with humerus shaft fractures, suggesting it may be the preferred surgical option for better patient outcomes but no significant difference in complications like delayed union and infection. Further research is warranted to validate these findings and refine treatment guidelines.
Metrics
References
Gallusser N, Barimani B, Vauclair F. Humeral shaft fractures. EFORT Open Rev. 2021;6(1):24-34. DOI: https://doi.org/10.1302/2058-5241.6.200033
Sarmiento A, Kinman PB, Galvin EG, Schmitt RH, Phillips JG. Functional bracing of fractures of the shaft of the humerus. J Bone Joint Surg. 1977;59(5):596-601. DOI: https://doi.org/10.2106/00004623-197759050-00004
Schoch B, Padegimas E, Maltenfort M, Krieg J, Namdari S, Schoch BS, et al. Humeral shaft fractures: national trends in management. J Orthop Traumatol. 2017;18(3). DOI: https://doi.org/10.1007/s10195-017-0459-6
Thakor K. Comparison of outcome of shaft humerus fracture: Anterior bridge plating versus posterior plating vs humerus intramedullary nailing. Int J Orthop. 2021;7(1):79-82. DOI: https://doi.org/10.22271/ortho.2021.v7.i1b.2461
Boer PD, Buckley M, Richard, Hoppenfeld M, Stanley. The Humerus. Surgical Exposures in Orthopaedics. 3rd edition. Wolters Kluwer Health. 2021;83-93.
Bhandari M, Devereaux PJ, McKee MD, Schemitsch EH. Compression plating versus intramedullary nailing of humeral shaft fractures: a meta-analysis Acta Orthop. 2006;77:279-84. DOI: https://doi.org/10.1080/17453670610046037
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. J Bone Joint Surg Br. 2000;82(3):336-9. DOI: https://doi.org/10.1302/0301-620X.82B3.0820336
Bell MJ, Beauchamp CG, Kellam JK, McMurtry RY. The results of plating humeral shaft fractures in patients with multiple injuries. The Sunnybrook experience. J Bone Joint Surg Br. 1985;67(2):293-6. DOI: https://doi.org/10.1302/0301-620X.67B2.3980544
Heim D, Herkert F, Hess P, Regazzoni P. Surgical treatment of humeral shaft fractures: the Basel experience. J Trauma. 1993;35:226-32. DOI: https://doi.org/10.1097/00005373-199308000-00009
Davies G, Yeo G, Meta M, Miller D, Hohmann E, Tetsworth K. Case-Match Controlled Comparison of Minimally Invasive Plate Osteosynthesis and Intramedullary Nailing for the Stabilization of Humeral Shaft Fractures. J Orthop Trauma. 2016;30(11):612-7. DOI: https://doi.org/10.1097/BOT.0000000000000643
Patel YC, Patel VD. A study of anterior bridge plating with MIPO technique for fracture shaft humerus. Int J Orthop. 2020;6(1):92-6. DOI: https://doi.org/10.22271/ortho.2020.v6.i1b.2054
Kulkarni VS, Kulkarni MS, Kulkarni GS, Goyal V, Kulkarni MG. Comparison between antegrade intramedullary nailing (IMN), open reduction plate osteosynthesis (ORPO) and minimally invasive plate osteosynthesis (MIPO) in treatment of humerus diaphyseal fractures. Injury. 2017;48(2):S8-S13. DOI: https://doi.org/10.1016/S0020-1383(17)30487-4
Downloads
Published
How to Cite
Issue
Section
