Abstract: Introduction: Fracture of shaft of humerus is a common fracture of the upper limb which consists of 1-3% of all fractures. The most common method of fixation is open reduction internal fixation with plate and screw, and closed reduction with intramedullary nail fixation. The purpose of this study was to evaluate the clinical outcome of plate fixation versus intramedullary nail fixation. The study of fractures of shaft of humerus is important due to chances of these fractures to go in mal-union and non-union and the functional disability to the patient after these fractures being a hindrance in earning their daily living.
Material and Method: We randomly followed 50 cases of humeral shaft fracture of which 24 treated by closed reduction and intramedullary nailing and 26 treated with open reduction and platting. Union, functional outcome and complication were compared between both the groups. Evaluation of follow-up as per ASES (American shoulder and elbow surgeons) score was done on last follow-up.
Result: The average age of patient was 37.8 years; most common site was middle 1/3rd shaft of humerus. The average duration to achieve union with closed reduction and intramedullary nailing is 10.91 weeks and average duration of union with open reduction and platting was 12 weeks. Functional outcome was assessed by using ASES score value. The average ASES score for platting was 80.36 and that of nailing was 76.23. Complications like Non-union (12.5%), iatrogenic nerve injury (11.5) and infection (7.7%) were encountered in plate group where in IM nail group Non-union (12.5%), shoulder stiffness (16.6%) and impingement.
Conclusion: Functional outcome of Platting group is better than IM nail. Early mobilisation with IM nailing is advantage compare to platting. IM nail when used, one has to take precautions, like proper countersinking of the nail at entry point to prevent shoulder movement restriction, irrigation of entry point site to remove all reamed bone debris. Careful dissection of rotator cuff to prevent its damage.
