Vol. 11, Issue 2 (2025)

Background: Many studies are conducted on this topic but most of them conclude no difference in outcomes by as such. The treatment of humeral shaft is still controversial. Most are treated nonsurgically, but when indicated choosing between nail and plate is difficult. The aim of our study was to compare shoulder range of motion and complications after interlocking medullary nail(IMN) and locking plate (LP) in treatment of this kind of fracture.

Materials and Methods: We acquired a data on 57 patients with closed humerus shaft fractures and out of which 27 were treated with LP and 30 were treated with IMN. We compared in the 2 groups final range of motion, full recovery rate, functional outcomes, residual pain, complications and elbow flexion-extension range. The functional outcomes were measured at 1, 3, 4, and 6 months by using Rodríguez-Merchán scoring.

Results: No patient in the two groups developed a non-union. There was no difference in both groups in elbow flexion-extension. Group LP had a full shoulder range of motion (66.6% vs. 40.0%; P¼ .02) and excellent Rodríguez-Merchan scoring (66% vs. 40.0%; p< .01), that was statistically better than in group IMN. In group LP, the Constant score was 95 (IQR 9).

Discussion: Our study results conclude a hierarchy of LP over IMN in terms of higher range of motion and a better anatomical and fixed reductions of the fracture and fewer complications. Whereas IMN appeared to be better over LP in terms of leading to a lower rate of infectious complications. The two treatments achieved comparable results in terms of operation time, hospital stay, union time and elbow flexion-extension. The Rodríguez-Merchan scores were significantly higher in patients with LP.

Conclusion: The study led to conclusion that Locking plate(LP)was more better and effective in terms of achieving higher ROM with optimal functional outcomes compared to Interlocking medullary nail (IMN) for closed shaft humerus fractures requiring surgical intervention. A larger sample size with equal representation in both groups is required for a p value with higher significance.