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

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

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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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Randomized controlled trial comparing dynamic compression plate versus intramedullary interlocking nail for management of humeral shaft fractures

Health Renaissance ◽

10.3126/hren.v9i2.4974 ◽

1970 ◽

Vol 9 (2) ◽

pp. 61-66 ◽

Cited By ~ 2

Author(s):

P Chaudhary ◽

NK Karn ◽

BP Shrestha ◽

GP Khanal ◽

R Rijal ◽

...

Keyword(s):

Standard Deviation ◽

Blood Loss ◽

Functional Outcome ◽

Dynamic Compression ◽

Operating Time ◽

Humeral Shaft ◽

Dynamic Compression Plate ◽

Interlocking Nail ◽

Humeral Shaft Fractures ◽

Compression Plate

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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Dynamic compression plating versus locked intramedullary nailing for humeral shaft fractures in adults

Cochrane Database of Systematic Reviews ◽

10.1002/14651858.cd005959.pub2 ◽

2011 ◽

Cited By ~ 22

Author(s):

Harish Kurup ◽

Munier Hossain ◽

J Glynne Andrew

Keyword(s):

Intramedullary Nailing ◽

Dynamic Compression ◽

Humeral Shaft ◽

Humeral Shaft Fractures ◽

Shaft Fractures ◽

Compression Plating ◽

Dynamic Compression Plating

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Dynamic compression plating versus locked intramedullary nailing for humeral shaft fractures: a meta-analysis of RCTs and nonrandomized studies

Journal of Orthopaedic Science ◽

10.1007/s00776-013-0497-8 ◽

2014 ◽

Vol 19 (2) ◽

pp. 282-291 ◽

Cited By ~ 20

Author(s):

Jiezhi Dai ◽

Yimin Chai ◽

Chunyang Wang ◽

Gen Wen

Keyword(s):

Intramedullary Nailing ◽

Dynamic Compression ◽

Meta Analysis ◽

Humeral Shaft ◽

Humeral Shaft Fractures ◽

Shaft Fractures ◽

Compression Plating ◽

Dynamic Compression Plating

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Locked Intramedullary Nailing versus Dynamic Compression Plating for Humeral Shaft Fractures

Journal of Orthopaedic Surgery ◽

10.1177/230949900901700202 ◽

2009 ◽

Vol 17 (2) ◽

pp. 139-141 ◽

Cited By ~ 48

Author(s):

Amit B Putti ◽

Rajendra B Uppin ◽

Babu B Putti

Keyword(s):

Intramedullary Nailing ◽

Functional Outcomes ◽

Dynamic Compression ◽

Adhesive Capsulitis ◽

Humeral Shaft ◽

Complication Rates ◽

Humeral Shaft Fractures ◽

Shaft Fractures ◽

Compression Plating ◽

Dynamic Compression Plating

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.

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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.

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