International Journal of Orthopaedics Sciences
2018, Volume 4 Issue 4
Is dynamic compression plate better than interlocking nail in treatment of adult fracture shaft of Humerus? - A prospective comparative study
Author(s): Dr. Sudhir KAM Shandilya, Dr. Kota Aditya, Dr. Meeravali Shaik and Dr. Ch VS Krishna Teja
Abstract: Introduction: In past all fracture shaft humerus due to low velocity trauma was managed conservatively. However, in recent years the increasing high-speed motor vehicular accidents has posed a greater challenge on treating surgeon for managing varied patterns of those fractures. The advances in implants, operative techniques and expectations of the patients has led to change in the perspective of management towards more of surgical treatment. Material and methods: For closed fracture shaft humerus two main modalities of fixation are available. 1. ORIF using DC plate, 2. CRIF using intramedullary interlocking nails. This study intends to study and compare the advantages and disadvantages of both modalities. Two groups of 15 patients each having fracture shaft of humerus were managed by above two methods from July 2015 – Dec 2017. The results were assessed on following points: primary union rate, time needed for union, incidence of complications and functional scoring was done using Stewart and Hundley criteria. Results: There were 9 (60%) excellent results in the DCP group and 4 (27%) in interlocking group. 5(33%) good results in the DCP group and 4(27%) in interlocking group. 5 (33%) fair results in interlocking group and none in DCP group. 2(13%) under interlocking group and 1(7%) under plating group got poor. The complications were more in the interlocking group with most of them pertaining to poor shoulder function with pain. Though both modalities of treatment offer good union, the rate of secondary complication were more with interlocking nail, which makes dynamic compression plating a more favorable option. Conclusion: Open reduction and internal fixation with a DCP remains a better treatment option as against intramedullary interlocking nails for fractures of the shaft humerus.