Abstract: Background and purpose:
Simple humeral shaft fracture can be treated non operatively, with good results in most cases but the non-operative treatment requires a long period of immobilization, which carries a risk of prolonged shoulder joint stiffness and may be inconvenient for the patient.
Furthermore, nonunion after conservative treatment of these fractures does occur in up to 10% of the cases and treatment of this condition can be very difficult. Now there is growing interest in treating even simple humeral shaft fractures by dynamic compression plate (DCP) or interlocking nail (ILN) in order to avoid these problems and to allow earlier mobilization and rapid return to work.
Methods: 40 patients of fracture shaft of Humerus were included in the study.20 were managed by Interlocking Nail and 20 were managed by dynamic compression plate.Patients were called for follow up after every four weeks after the stitch removal and on each follow up visit, functional and radiological assessment done by predesigned performa. The functional results assessed at the end of 6 months and 1 year postoperatively on the bases of ASES Score (table 2), for 13 activities of daily living requiring full shoulder and elbow movement.
Results: At the end of study, 23 (92%) cases in DCP group had acceptable (either good or more than good) results compared to 22(88%) cases of IMN group, having similar results. The mean interval between admissions to surgery, average operating time, duration of hospital study after surgery was less in DCP group while incidence of serious post-operative complications was more in IMN group. There was no statistically significant difference between the two groups with regards the average time taken for radiological union, although the mean radiological union in DCP group occurred 1.6 weeks earlier compared to the IMN group.
Interpretation:On the basis of this study, we found that DCP can be considered a better surgical option for the management of fracture of the shaft of humerus in our setting as it offers a shorter admission to surgery interval; shorter operating time and shorter hospital stay after surgery besides the lower incidence of more serious complication like the radial nerve palsy and infection otherwise comparable to IMN in all other variables of interest in our study.