A retrospective comparative study of plate osteosynthesis and intramedullary nailing in humerus shaft fractures

Author(s): Dr Arnab Sinha, Dr Santosh Kumar

Abstract: Fractures of the humeral shaft account for roughly 3% of all fractures, most can be treated non operatively. The range of motion afforded by the shoulder and elbow joints, coupled with a tolerance for small amounts of shortening, allow radiographic imperfections that cause minimal functional deficit and are well tolerated by the patient. In recent times, more and more cases are being operated, in view of the advantages of operative treatment. Operative treatment results in a more predictable alignment and faster healing which makes early mobilisation possible. The advantages, disadvantages, and risks of both nonoperative and operative treatment should be discussed with the patient before a decision is made. We did a retrospective study of 30 cases of fracture shaft of humerus of which 15 were fixed with compression plating and 15 with an interlocking nailing To compare the results of compression plating and interlocking nailing in the treatment of fracture shaft of humerus with reference to 1.the time of healing, 2.functional outcome and 3.complications like infection, failure of implant and neurovascular injuries. If there are no clinical and radiological signs of union by 18 weeks, the fracture was categorized as delayed union and absence of fracture union after 32 weeks after injury was categorized as non-union. The functional outcome was measured by the "Disabilities of Arm, Shoulder and Hand" (DASH) Questionnaire at nine months or at full recovery whichever was earlier. The result was then graded as Excellent (0 to 20 Points), Good (21 to 40 points), Fair (41 to 60 points), Poor (> 60 points).The time taken for healing, the functional outcome and the complications in both groups were then compared. A review of the available relevant literature was also done.