DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20173656

Comparative study of operative management of humeral shaft fractures by dynamic compression plating versus locked intra-medullary nailing

Kiran Kumar Koppolu Kanthi, Maheshwar Lakkireddy, Vikas Reddy Bollavaram, Siva Prasad Rapur

Abstract


Background: Operative management of humeral shaft fractures is mostly accomplished by surface plating or intra-medullary nail osteosynthesis. Both the treatment options have been variably reported to give good rates of union and functional outcome. We compared both the options to know the better one in multitude of variables.

Methods: Thirty patients with fracture shaft of humerus were followed up for a period of 12 to18 months. 15 patients each underwent open reduction and internal fixation with dynamic compression plate and closed antegrade locked intra-medullary nailing. All patients were clinically and radiologically assessed till fracture union.

Results: Diaphyseal humeral fractures in all the patients treated with nailing united and had a tendency to unite early compared to plating. Shoulder pain was initially complained by 2 patients from the nailing group and got subsided later on. The incidence of complications was more in the plate osteosynthesis group.

Conclusions: In our study Intra-medullary nailing turned out to be superior to plating for amenable diaphyseal fractures of humerus in terms of higher rate of union, early union and lesser complications.


Keywords


Humeral shaft fracture, Plate osteosynthesis, Intra-medullary nailing, Fracture union

Full Text:

PDF

References


Singisetti K, Ambedkar M. Nailing versus plating in humerus shaft fractures: a prospective comparative study. Int Orthop. 2010;34(4):571-6.

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.

Ghosh S, Halder TC, Chaudhuri A, Datta S, Dasgupta S, Mitra UK. Comparative study of operative treatment of mid shaft fracture of humerus by locking plate versus intramedul¬lary interlocking nail. Med J of Dr DY Patil University. 2013;6(4):390-4.

Fan Y, Li Y, Zhang H, Liu J, Han X, Chang X, et al. Management of Humeral Shaft Fractures With Intramedullary Interlocking Nail Versus Locking Compression Plate. Orthopaedics. 2015;38:825-9.

Garnavos C. Humeral shaft fractures. Rockwood and Green’s fractures in adults. In: Charles M. Court-Brown, James D. Heckman, Margaret M. McQueen, William Ricci, Paul Tornetta III, editors. Wolters Kluwer; 2015: 1287-1340.

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;41:214-8.

Ring D, Jupiter JB. Internal fixation of the humerus with locking compression plates. Tech Shoulder Elbow Surg. 2003;4(4):169-74.

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. 2007;31(3):391-5.

Rommens PM, Kuechle R, Bord T, Lewens T, Engelmann R, Blum J. Humeral nailing revisited. Injury. 2008;39(12):1319-28.

Ajmal M, O’Sullivan M, McCabe J, Curtin W. Antegrade locked intramedullary nailing in humeral shaft fractures. Injury. 2001;32(9):692-4.

Kurup H, Hossain M, Andrew JG. Dynamic compression plating versus locked intramedullary nailing for humeral shaft fractures in adults. Cochrane Database Syst Rev. 2011;6:CD005959.

Dai J, Chai Y, Wang C, Wen G. Dynamic compression plating versus locked intramedullary nailing for humeral shaft fractures:a meta-analysis of RCTs and nonrandomized studies. J Orthop Sci. 2014;19(2):282-91.

Azar FM, Beaty JH, Canale ST. Campbell’s operative orthopaedics, thirteenth edition. Chapter 57 Fractures of the shoulder, arm, and forearm. Elsevier. 2017: 2957.