Comparative study of functional outcome of dynamic compression plating and interlocking intramedullary nailing for fructure shaft of humerus


  • Aminul Islam Mamood Junior Resident, Department of Orthopaedics, Katihar Medical College, Katihar, Bihar, India
  • Ajay Kumar Mahto Professor and Head, Department of Orthopaedics, Katihar Medical College, Katihar, Bihar, India



Shaft, Humerus, Nail, Plate


Background: Fracture of the diaphysis of humerus and its complications are a major cause of morbidity in trauma patients. Fracture of the humeral shaft account for 20% of humeral fractures & about 3% of all fractures. There is a debate between the choices of operation in humeral shaft fractures.

Methods: A comparative study of management of acute humeral shaft fractures treated by Dynamic Compression Plate (DCP) and Intra Medullary Interlocking Nail (IMILN) fixation over a period of one half years. 18 patients of IMILN and 20 patients of DCP were included after considering inclusion and exclusion criteria. Functional scoring criteria were used for postoperative assessment & the average follow up period was one year.

Results: A high rate of excellent & good results & a tendency for early union was seen with the plating group than nailing group.

Conclusions: Plating shows better results than nailing.


Tsai CH, Fong YC, Chen YH, Hsu CJ, Chang CH, Hsu HC. The epidemiology of traumatic humeral shaft fractures in Taiwan. Int Orthop. 2009;33(2):463–7.

Foster RJ, Dixon GL Jr, Bach AW, Appleyard RW, Green TM. Internal fixation of fractures and non-unions of the humeral shaft. Indications and results in a multi-center study. J Bone Joint Surg Am. 1985;67(6):857–64.

Sarmiento A, Kinman PB, Galvin EG, Schmitt RH, Phillips JG. Functional bracing of fractures of the shaft of the humerus. J Bone Joint Surg Am. 1977;59A:596–601.

Sarmiento A, Waddell JP, Latta LL. Diaphyseal humeral fractures: Treatment options. Instr Course Lect. 2002;51:257–69.

Rodríguez-Merchán EC. Compression plating versus Hackethal nailing in closed humeral shaft fractures failing nonoperative reduction. J Orthop Trauma. 1995;9(3):194–7.

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.

Hall RF Jr, Pankovich AM. Ender nailing of acute fractures of the humerus. A study of closed fixation by intramedullary nails without reaming. J Bone Joint Surg Am. 1987;69(4):558–67.

Klenerman L. Fractures of the shaft of the humerus. J Bone Joint Surg Br. 1996;48(1):105–11.

Chao TC, Chou WY, Chung JC, Hsu CJ. Humeral shaft fractures treated by dynamic compression plates, Ender nails and interlocking nails. Int Orthop. 2005;29(2):88–91.

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 randomized trial. J Bone Joint Surg Br. 2000;82(3):336–9.

Pollock FH, Drake D, Bovill EG, Day L, Trafton PG. Treatment of radial neuropathy associated with fractures of the humerus. J Bone Joint Surg Am. 1981;63(2):239–43.

An Z, Zeng B, He X, Chen Q, Hu S. Plating osteosynthesis of mid-distal humeral shaft. fractures: minimally invasive versus conventional open reduction technique. Int Orthop. 2010;34(1):131–5.

Ji F, Tong D, Tang H, Cai X, Zhang Q, Li J, Wang Q. Minimally invasive percutaneous plate osteosynthesis (MIPPO) technique applied in the treatment of humeral shaft distal fractures through a lateral approach. Int Orthop. 2009;33(2):543–7.

Livani B, Belangero W, Andrade K, Zuiani G, Pratali R. Is MIPO in humeral shaft fractures really safe? Postoperative ultrasonographic evaluation. Int Orthop. 2009;33(6):1719-23.

Brumback RJ, Bosse MJ, Poka A, Burgess AR. Intramedullary stabilization of humeral shaft fractures in patients with multiple trauma. J Bone Joint Surg Am. 1986;68(7):960–70.

Bhandari M, Devereaux PJ, McKee MD, Schemitsch EH. Compression plating versus intramedullary nailing of humeralshaft fractures; a meta-analysis. Acta Orthop. 2006;77(2):279–84.

Chapman JR, Henley MB, Agel J, Benca PJ. Randomized prospective study of humeral shaft fracture fixation: Intramedullary nails versus plates. J Orthop Trauma. 2000;14:162–6.

Changulani M, Jain UK, Keswani T. Comparison of the use of the humerus intramedullary nail and dynamic compression Fig. 2 a Radiograph of poor results with bending of interlocking nail. b Radiograph after exchange nailing plate for the management of diaphyseal fractures of the humerus.A randomised controlled study. Int Orthop. 2007;31(3):391–5.

Raghavendra S, Bhalodiya HP. Internal fixation of fractures of the shaft of the humerus by dynamic compression plate or intramedullary nail: A prospective study. Indian J Orthop. 2007;41(3):214–8.

Stern PJ, Mattingly DA, Pomeroy DL, Zenni EJ Jr, Kreig JK. Intramedullary fixation of humeral shaft fractures. J Bone Joint Surg Am. 1984;66(5):639–46.






Original Research Articles