Open AccessComparative study of operative treatment of mid shaft fracture of humerus by locking plate versus intramedullary interlocking nail
Author(s) -
Shilpi Ghosh,
Tarak Chandra Halder,
Arunima Chaudhuri,
Soma Datta,
Sudipta Dasgupta,
Utpal Kumar Mitra
Publication year - 2013
Publication title -
medical journal of dr. d y patil university/medical journal of dr. d.y. patil university
Language(s) - English
Resource type - Journals
eISSN - 2278-7119
pISSN - 0975-2870
DOI - 10.4103/0975-2870.118282
Subject(s) - intramedullary rod , medicine , elbow , dynamic compression plate , surgery , humerus , humeral shaft , humerus fracture , radiological weapon , internal fixation
Background: Treatment of humeral shaft fractures with intramedullary nailing compared with dynamic compression plating leads to comparable results. No single treatment option is superior in all circumstances for a particular fracture and each case has to be individualized . Objectives: Comparative assessment of results of plating and Intramedullary Nailing in a rural set up so that proper management techniques can be provided for better functional outcome and minimum complications. Materials and Methods: This prospective study was conducted over a period of three years on sixty patients with closed acute humeral shaft fracture requiring operative interventions. Results: Forty percent of cases were in the age group 31-40 years with males outnumbering females. Motor vehicle accidents (63.3%) were most frequent cause. Right humerus was more frequently (66.6%) involved. Maximum patients (40%) were operated within 4-6 days after injury. Out of 30 patients of plate group complications were: Infection-6.6%; delayed union-13.3%; shoulder movement restriction-13.3%; elbow movement restriction-6.6%. Out of 30 patients of nail group complications were: Splintering of fracture end-6.6%; infection-6.6%; delayed union-26.6%; shoulder movement restriction-13.3%; elbow movement restriction-6.6%; shoulder pain-46.6%. Maximum number of fractures (73.3% in plating group and 60% in nailing group) clinically united in the interval of 11-13 weeks. Maximum number of patients had radiological union in period of 12-16 weeks (73.3% plate group and 66.6% nail group). There was no significant difference between the two groups. On functional assessment, excellent results were obtained in 22 patients (73.3%) in locking plate group and 18 patients (60%) in locking nail group. Conclusion: For patients requiring surgical treatment of mid shaft humeral fractures, locking plating and interlocking intramedullary nailing both provide statistically comparable results but a higher rate of excellent and good results and a tendency for earlier union was seen with locking plating group in the present series