Management of Humeral Shaft Fracture: A Comparative Study between Interlocking Nail and Dynamic Compression Plating

Background: Aim of the study was to compare the functional outcome in patients with fracture shaft of the humerus treated with dynamic compression plating (DCP) and those treated with intramedullary interlocking nailing.Methods: Of 44 patients with humeral shaft fracture were included in this study and were divided in the following two groups of 22 patients: Group A: Patients treated with DCP by triceps splitting approach and group B: Patients treated with standard intramedullary interlocking nailing. All patients were followed up at 6 weeks, 3 months and 6 months post operatively. Functional outcome was assessed using Rodriguez-Merchan criteria on follow up at 6 months post op.Results: The mean age of patients in group A was 39.05±13.13 years and group B was 38.73±12.95 years. According to Rodriguez-Merchan criteria, 8 (36.4%) and 12 (54.6%) patients in group A had excellent and good functional outcome respectively and 4 (18.2%) and 10 (45.4%) patients in group B had excellent and good functional outcome respectively.Conclusions: DCP offers better functional outcome than interlocking nailing.

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Treatment of fracture of shaft of humerus in adults by intramedullary interlocking nail fixation

Health Renaissance ◽

10.3126/hren.v13i2.17565 ◽

2017 ◽

Vol 13 (2) ◽

pp. 153-159

Author(s):

Pashupati Chaudhary ◽

NK Karn ◽

BP Shrestha ◽

GP Khanal ◽

RPS Kalawar

Keyword(s):

Standard Deviation ◽

Blood Loss ◽

Dynamic Compression ◽

Operating Time ◽

Humeral Shaft ◽

Dash Score ◽

Interlocking Nail ◽

The Mean ◽

Compression Plating ◽

Dynamic Compression Plating

Backgroud: The optimal method of humeral shaft fracture fixation remains in debate. 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. There are very few studies comparing intramedullary interlocking nail and dynamic compression plating in fracture shaft of humerus and virtually no study in this part of world.Objective: The aim of the study was to assess the fixation of fracture shaft of humerus with interlocking nail and 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), complications of surgery.Method: This was respective interventional study. All patients with fractures of shaft of humerus that met the criteria for operative interventions (intramedullary interlocking nail) presenting to the department of Orthopaedics BPKIHS over a period of 3 years from July 2006 to August 2009 and giving informed consent were included in the study. The study enrolled 30 patients.Result: Among 30 patients, 75% were male and 25% were female. The mean age of patients was 34.5 years. The usual mode of injury were road trafiic accident followed by fall from height, work place injury. Most of the patients were right handed. The operating time was 100 mins with standard deviation of 11.24. The mean blood loss was 148.75 with standard deviation of 36.70. Post operative hospital stay was 4.5 days. The peroperative radial nerve palsy was 4%. Radiologically, four cortices union was only 50% in 24 weeks post operative time. Dash score gradually improved in susequent followed up. Conclusion: It is concluded that dynamic compression plating is better in our study for fracture shaft of humerus. Plate osteosynthesis remains the gold standard of fixation for humeral shaft fractures.Health Renaissance 2015;13(2): 153-159

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Management of humeral shaft fracture: a comparative study between interlocking nail and dynamic compression plating

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20161457 ◽

2016 ◽

Author(s):

Golam Hashib

Keyword(s):

Dynamic Compression ◽

Sinus Tract ◽

Humeral Shaft ◽

Daily Activities ◽

Non Union ◽

Interlocking Nail ◽

Group A ◽

Group B ◽

Compression Plating ◽

Dynamic Compression Plating

Background: Fractures of humeral shaft are commonly encountered by orthopaedic surgeons accounting for approximately 3% of all fractures. Treatment of these injuries continues to evolve as advances are made in both operative and non-operative management. Most humeral shaft fractures can be managed non-operatively with anticipated good to excellent results.Methods: 29 cases with fracture of shaft of humerus were treated operatively in the Department of Orthopaedics, Katihar Medical College. Out of these, 15 cases (Group-A) underwent internal fixation by humeral interlocking nail and 14 cases (Group-B) underwent internal fixation by dynamic compression plating, with or without bone grafting. Bone grafting was done in 8 cases of Group-A and 5 cases of group-B.Results: All cases, except one from each group returned to their previous occupation. Both these cases developed non-union. They were able to perform daily activities but not able to resume their occupation. Thus the functional result was good in 92.3% of cases and poor in 7.7% of cases of either group. 4 cases in group-B (30.8%) managed by dynamic compression plating developed infections. In this study complications were also observed. Two of them were superficial infections that responded well to antibiotics and dressings and later healed well and united. Two cases developed discharging sinuses and subsequently infected union. Later the plate was removed and sinus tract excised. The sinus tract healed but left unsightly scar marks over the arm. Only one patient (7.7%) of group-A developed deep seated infection and subsequent non-union. 3 cases of group-A (23.1%) developed shortening ranging from 1.5cm to 4cm. All these cases were cases of old non-union with sclerotic bone ends which had to be nibbled and refreshed. Shortening developed in 2 cases (15.4%) of group-B. One non-union was seen in each group. While the screws of one dynamic compression (7.7%) went loose, no implant failure occurred in interlocking nails. One case (7.7%) of group-A developed axillary nerve injury, which might be attributed to the fact that the incision extended 6-7 cm beyond the acromion process. Only one case in group-B developed 10o angulation.Conclusions: Dynamic compression plating has stood the test of time as an excellent method of stabilizing transverse diaphyseal fractures of humerus. The plate produces a compression at the fracture site promoting osteosynthesis. But the technique is not suitable for segmental fractures, pathological fractures, communited fractures, gross osteoporosis, non-union and fractures much proximal or distal to shaft. Introduction of interlocking nailing has largely solved problems faced by the standard dynamic compression plating technique. An advantage of humerus interlocking is that even when non-union developed daily activities could be performed whereas in cases with loosening of screws it was difficult to do so.

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Operative Treatment of the Humeral Shaft Fracture: Comparative Study of Dynamic Compression Plate and Interlocking Intramedullary Nail

Journal of the Korean Fracture Society ◽

10.12671/jksf.2002.15.3.391 ◽

2002 ◽

Vol 15 (3) ◽

pp. 391 ◽

Cited By ~ 2

Author(s):

Jeung Tak Suh ◽

Sung Won Jung ◽

Ja Kyung Ku ◽

Chong Il Yoo

Keyword(s):

Comparative Study ◽

Operative Treatment ◽

Intramedullary Nail ◽

Dynamic Compression ◽

Shaft Fracture ◽

Humeral Shaft Fracture ◽

Humeral Shaft ◽

Dynamic Compression Plate ◽

Compression Plate ◽

Interlocking Intramedullary Nail

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A comparative study of operative dynamic compression plating versus non-operative management in fracture shaft of humerus

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20200741 ◽

2020 ◽

Vol 6 (2) ◽

pp. 374

Author(s):

Naren Gaur ◽

Naveen Kumar Singh

Keyword(s):

Comparative Study ◽

Functional Outcome ◽

Operative Treatment ◽

Dynamic Compression ◽

Operative Management ◽

Shaft Fracture ◽

Nonoperative Treatment ◽

Humerus Shaft ◽

Compression Plating ◽

Dynamic Compression Plating

Background: Fracture shaft of humerus is among injuries which is commonly seen in clinical practice and frequently seen in polytrauma. Humerus shaft fractures account for 3% of all orthopedic injuries. Nonoperative treatment had been the mainstay of treatment for fracture shaft of humerus earlier. The association of conservative treatment with some morbidity, complications and prolonged immobilization leads to increase in various operative modalities of management. One of the commonly used operative modality is dynamic compression plating (DCP). In view of above considerations, a study was undertaken at our hospital which aimed to compare non-operative treatment with operative DCP for the management of fracture shaft of humerus. Aims and objectives of this study to compare the results of non-operative versus operative treatment of humerus shaft fracture.Methods: It was a prospective comparative study. Total 40 patients were taken for this study. 20 patients for operative and 20 patients for non-operative. Functional outcome was measured by the DASH scoring. P<0.05 was considered statistically significant. Results: Among the 40 patients 14 had excellent results, 12 had good, 8 had fair and 6 had poor results. Functional outcome scores were better for operative group as compared to non- operative group with p<0.0001. Conclusions: Dynamic compression plating of humerus is better method than conservative method because it achieves higher union rates.

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