Antegrade Interlocking Nailing versus Dynamic Compression Plating for Humeral Shaft Fractures

Purpose. To compare functional outcomes, union and complication rates in patients treated with locked intramedullary nailing or dynamic compression plating for humeral shaft fractures. Methods. 32 men and 2 women with humeral shaft fractures were randomised to undergo locked antegrade intramedullary nailing (IMN, n=16) or dynamic compression plating (DCP, n=18). Patients with pathological fractures, grade-III open fractures, neurovascular injury, or fractures for more than 2 weeks were excluded. Fractures were classified according to the AO classification system (one in A1, 6 in A2, 12 in A3, 6 in B1, and 9 in B2). 28 were injured in road traffic accidents. The functional outcome (according to the American Shoulder and Elbow Surgeons [ASES] score) and rates of union and complication of the 2 groups were compared. Results. All patients were followed up for a minimum of 24 months. In the respective IMN and DCP groups, the mean ASES scores were 45.2 and 45.1 (p=0.69), the complication rates were 50% and 17% (p=0.038), and the non-union rates were 0% and 6% (p=0.15). In the IMN group, 2 sustained iatrogenic fractures during nail insertion; 2 had transient radial nerve palsies; one underwent nail removal for shoulder impingement; and 3 had adhesive capsulitis. In the DCP group, one underwent re-operation for implant failure; one had a superficial infection; and one developed adhesive capsulitis. Conclusion. The complication rate was higher in the IMN group, whereas functional outcomes were good with both modalities.

Download Full-text

Ender Nail versus Dynamic Compression Plating For Humeral Shaft Fractures

International Journal of Orthopaedics Sciences ◽

10.22271/ortho.2018.v4.i1e.45 ◽

2018 ◽

Vol 4 (1e) ◽

pp. 313-315

Author(s):

Dr. Pawan Kumar ◽

Dr. Vidya Sagar ◽

Dr. Ashutosh Kumar ◽

Dr. Santosh Kumar

Keyword(s):

Dynamic Compression ◽

Humeral Shaft ◽

Humeral Shaft Fractures ◽

Shaft Fractures ◽

Compression Plating ◽

Dynamic Compression Plating

Download Full-text

Dynamic Compression Plate Versus Intramedullary Interlocking Nail for Managemaent of Humeral Shaft Fractures

Nepal Orthopaedic Association Journal ◽

10.3126/noaj.v3i2.9513 ◽

2014 ◽

Vol 3 (2) ◽

pp. 10-13

Author(s):

Pashupati Chaudhary ◽

Navin Kumar Karn ◽

Bikram Prasad Shrestha ◽

Guru Prasad Khanal ◽

Shivraj Paneru ◽

...

Keyword(s):

Blood Loss ◽

Dynamic Compression ◽

Operating Time ◽

Humeral Shaft ◽

Dash Score ◽

Interlocking Nail ◽

Humeral Shaft Fractures ◽

Shaft Fractures ◽

Plate Group ◽

Compression Plating

Introduction: With the dramatic success of intramedullary fixation for fractures of the femur and tibia, there was speculation that Intramedullary Interlocking Nails might be more appropriate for humeral shaft fractures in comparison to Dynamic Compression Plates. There are very few studies comparing these two methods of fixation in shaft of humerus fractures and virtually no study in this part of world. The aim of the study was to compare these fixation methods 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 randamised control trial in which all patients with fractures of shaft of humerus that met the criteria for operative interventions ( intramedullary interlocking nailing and dynamic compression plating) presenting to the department of Orthopaedics BPKIHS during the study period and giving informed consent were included in the study. The patients were randomized using Excel random number generation technique into two groups. N Group: Cases treated with intramedullary interlocking nail and P Group: Cases treated with dynamic compression plate. Results: Most of the patients were right handed. The operating time for nailing was 100±11.24 minutess in comparision to 90.25± 15.6 minutes for humerus plating. The mean blood loss in nail group was 148.75 ±36.70 while in plate group blood loss was 205±45.60. Post operative hospital stay was similar in both groups with mean stay of 4.5 days.The peroperative radial nerve palsy was 4% in nailing group as compared to 2% in plating group. Radiologically four cortices union was only 50% in nailing group while it was 80% in plating group at 24 weeks post operatively. Dash score gradually improved in both nail and plate group but Dash score was significantly higher in plating group at 6,12,18 and 24 weeks follow up. Conclusion: Dynamic compression plating is better for fracture shaft of humerus. Plate osteosynthesis remains the gold standard of fixation for humeral shaft fractures. DOI: http://dx.doi.org/10.3126/noaj.v3i2.9513 NOAJ July-December 2013, Vol 3, Issue 2, 10-13

Download Full-text

A4 Antegrade interlocking nailing versus locking compression plating for treatment of humeral shaft fractures

Injury ◽

10.1016/s0020-1383(11)70021-3 ◽

2011 ◽

Vol 42 ◽

pp. S1-S2

Author(s):

A. Baltov ◽

N. Tzachev ◽

A. Iotov

Keyword(s):

Humeral Shaft ◽

Humeral Shaft Fractures ◽

Interlocking Nailing ◽

Shaft Fractures ◽

Compression Plating

Download Full-text

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

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20173938 ◽

2017 ◽

Vol 3 (5) ◽

pp. 1038

Author(s):

Aminul Islam Mamood ◽

Ajay Kumar Mahto

Keyword(s):

Comparative Study ◽

Dynamic Compression ◽

Humeral Shaft ◽

High Rate ◽

Trauma Patients ◽

Humeral Shaft Fractures ◽

Shaft Fractures ◽

One Year ◽

Compression Plating

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.

Download Full-text

A prospective randomised control study on dynamic compression plating versus intra medullary interlocking nailing in humeral diaphyseal fractures

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20211388 ◽

2021 ◽

Author(s):

Muhammed Junaid Abdul ◽

Jojin Jose Chitten ◽

Ramasamy Balasubramaniam ◽

Rajamohan Rajesh

Keyword(s):

Functional Outcome ◽

Dynamic Compression ◽

Humeral Shaft ◽

Dash Score ◽

Interlocking Nailing ◽

Significant Difference ◽

Diaphyseal Fractures ◽

Control Study ◽

Compression Plating ◽

Dynamic Compression Plating

Background: Surgical fixation of humeral shaft fractures generally involves plating or nailing. Despite the extensive literature comparing outcomes after open reduction with internal fixation (ORIF) with plating and interlocking intramedullary nailing (ILIMN) for acute humeral diaphyseal fractures, the superior treatment strategy still remains controversial. The purpose of this study was to compare the functional outcome of each method of fixation (dynamic compression plating and interlocking nailing) for the shaft of humerus fracture and to analyse statistically significant difference in the results of these two methods in terms of functional outcome, rate of healing and complications.Methods: We conducted a prospective randomized control study and evaluated the results of 50 patients having humeral shaft fracture which were internally fixed with antegrade interlocking nailing (25 patients) and dynamic compression plating (DCP) plate (25 patients). Patients were followed up on average of 11.4 months and their radiological outcomes were assessed with plain radiography and with DASH score.Results: The plating group had statistically significant faster radiological healing and better DASH score compared to nailing group. Also, postoperative complication rate was higher in ILN group which was statistically significant.Conclusions: ORIF with DCP provides better results in terms of good functional outcome, faster radiological union and less post-operative complications compared to ILIM nailing. Hence, we concluded that plating is a superior option than nailing.

Download Full-text