OS3-24 Intramedullary nail vs dynamic compression plate in treating humeral shaft fractures

Injury ◽  
2016 ◽  
Vol 47 ◽  
pp. S10
Author(s):  
C. Bardas ◽  
H. Benea ◽  
D. Oltean ◽  
M. Paiusan ◽  
R. Tomoaia ◽  
...  
Author(s):  
Bharathi Raja K. V. ◽  
Ganesh G. Ram

<p class="abstract"><strong>Background:</strong> Humeral shaft fractures represents between 3% and 5% of all fractures of which a certain number of patients require surgical intervention. This study aims to determine the efficacy of dynamic compression plate in the treatment of humeral shaft fractures.</p><p class="abstract"><strong>Methods:</strong> A prospective study was carried out over a period of 2 years in Sri Ramachandra Medical College, Chennai including 30 cases of shaft of humerus fractures treated by open reduction and internal fixation using Dynamic Compression plate among which both comminuted and segmental closed shaft of humerus fractures were included. While open fractures and ipsilateral forearm and clavicle fractures were excluded. AO classification was used to classify the fractures and the average follow up period was two years. The American Shoulder and Elbow Surgeons (ASES) shoulder score and Romen al series grading were used.<strong></strong></p><p class="abstract"><strong>Results:</strong> We had 93.3% excellent/good result and 6.7% poor results. In our series we had one non-union, one delayed union and one case of deep infection.</p><p class="abstract"><strong>Conclusions:</strong> Proper preoperative planning, minimal soft tissue dissection, strict asepsis, proper postoperative rehabilitation and patient education were essential to obtain excellent results. Early post-operative mobilization following rigid fixation of the fracture of humerus, with DCP lowered the incidence of stiffness and sudecks dystrophy.</p>


Author(s):  
C. D. Deepak ◽  
Mahesh D. V. ◽  
Abdul Ravoof ◽  
Sankosh Krishna Sai

<p class="abstract"><strong>Background:</strong> Fractures of the humeral shaft account for roughly 3% to 5% of all fractures. The predominant causes of humeral shaft fractures include simple falls or rotational injuries in the older population and higher energy mechanisms in the younger patients including motor vehicle accidents, assaults, fall from height and throwing injuries. Treatment options for humeral fractures vary according to the type of fracture, age group, bone density, soft tissue status and associated complications. Surgical management of shaft humerus fractures by plating can be done mainly through Thompson’s (posterior) approach and Henry’s (antero-lateral) approach.</p><p class="abstract"><strong>Methods:</strong> The study was conducted in patients treated for shaft humerus fracture at Adhichunchanagiri Institute of Medical Science, BG Nagara from the month of August 2014 to January 2016. Twenty patients diagnosed as shaft humerus fracture were taken into the study, all were undergone open reduction and internal fixation using dynamic compression plate in Thompson’s and Henry approach. Patients’ age more than 18 years were taken up for the study. Patients were followed up at 3 weeks, 6 weeks, 6 months.<strong></strong></p><p class="abstract"><strong>Results:</strong> The sample consisted of twenty shaft humerus fracture patients with 10 males and 10 females. The patients’ ages were more than 18 years where 13 cases (65%) between 26 to 55 years. Among these 20 patients, 10 involved the right side and 10 involved the left side. All patients achieved clinical and radiological union at 6 month follow up. According to Constant Murley Score, excellent result were found in 11 patients (55%), good in 2 patients (10%) and fair in 7 patients (35%). According to Mayo elbow performance index, 17 patients showed excellent outcome (85%) and 3 patients showed good outcome (15%).</p><strong>Conclusions:</strong>Dynamic compression plating is the best modality of management for the internal fixation of humeral shaft fractures. It is found that the fracture fixation of upper and middle one-third humerus in Henry’s approach is easier, lower one-third humeral fractures are not possible because the plate at the supracondylar ridge poses difficulty to fix. Fracture fixation of the lower one third and middle one third is easier in Thompson’s approach because of the flat surface of the bone and offers better plate contour.<p> </p>


1970 ◽  
Vol 9 (2) ◽  
pp. 61-66 ◽  
Author(s):  
P Chaudhary ◽  
NK Karn ◽  
BP Shrestha ◽  
GP Khanal ◽  
R Rijal ◽  
...  

Background: The optimal method of humeral shaft fracture fixation remains debatable. With the dramatic success of intramedullary fixation for fractures of the femur and tibia, there was speculation that IM-ILN might be more appropriate for humeral shaft fractures than DCP. Objectives: To compare the fixation of fracture shaft of humerus with interlocking nail and dynamic compression plate in terms of duration of operating time, amount of blood loss, rate of infection, pain at the fracture site, time to achieve union, functional outcome (DASH score) and complications of surgery. Methods: This was randomised control trial study. All patients with fractures of shaft of humerus that met the criteria for operative interventions presenting to the Department of Orthopaedics, BPKIHS in the study period and giving informed consent were included in the study. Sample size was taken 30 in each group. Results: The usual mode of injury in both the groups were road traffiic accident followed by fall from height, work place injury. The operating time for nailing was 100 mins with standard deviation of 11.24 while that of humerus plating was 90.25 with standard deviation 15.6.The mean blood loss in nail group was 148.75 with standard deviation of 36.70 while that in plate group was 205.00 with standard deviation of 45.60. Post operative hospital stay was similar in both groups with mean stay of 4.5 days. DASH was significantly higher in plating group at 6,12,18 and 24 weeks follow up. This showed better functional outcome in nailing group. Conclusion: Dynamic compression plating is better than interlocking nail for fracture shaft of humerus. Keywords: shaft of humerus; interlocking nail; plate fixation DOI: http://dx.doi.org/10.3126/hren.v9i2.4974 Health Renaissance 2011: Vol.9 (No.2): 61-66


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