Comparative study of functional outcome of dynamic compression plating and interlocking nailing for fracture shaft of humerus in adults

K Ram Mohan, K Kishore Kumar, J Venkateshwarlu, T Ashwin kumar, B Pranav Krishna

Abstract


Introduction: Fractures of humeral shaft are commonly encountered by an orthopaedic surgeon, accounting for 1-2% of all fractures. Treatment of these injuries continues to evolve as advances are made both in operative and non-operative management. Most humerus fractures are managed non operatively
with anticipated good to excellent results. Surgery is indicated in certain settings, nature of injury, fracture pattern and also patient’s demand.
Objective: The aim of this study is to compare the functional outcomes of plating with nailing and also the results of this study with standard works reported in literature, in terms of rate of union in both fixations, the functional outcomes of the treatment and incidence of complications like non-union, infection, radial nerve palsy.
Setting: This study was conducted at the orthopedics department of a teaching hospital in India.
Design: This was 2 years prospective, longitudinal, hospital based, observational study, and its outcomes.
Participants: The study was done in 30 patients diagnosed as fractures of shaft of humerus of traumatic etiology meeting the inclusion & exclusion criteria, admitted at Mahatma Gandhi Memorial Hospital (attached to Kakatiya Medical College,Warangal), from December 2016 to November 2018.These patients
were randomized into two groups in which 15 cases were treated by open reduction and internal fixation using the dynamic compression plate (DCP) and 15 cases were treated with closed reduction and internal fixation with intramedullary interlocking nail (ILN).
Results: A detailed analysis of the functional outcome of 30 patients treated in the present study was done based on Rommen’s criteria, and out of 15 patients treated with dynamic compression plating,13 had excellent results, 2 had good results. In 15 patients treated with intramedullary interlocking nailing, 10 had excellent results and 3 had good results and 2 had poor result.
Conclusion: Based on our experience and results, we conclude that the transverse fractures of humerus shaft are better treated with ante grade intramedullary interlocking nail, and comminuted fracture shaft humerus and those fractures associated with neuro-vascular or soft tissue injuries are better treated with plating.

Keywords: Dynamic compression plate, Fracture shaft of humerus, Internal fixation, Interlocking nail, Rommen’s criteria.


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