Abstract: Introduction: It is generally admitted that most humeral shaft fractures can be managed successfully by non-operative methods. Whenever operative treatment is required, a choice has to be made between plate osteosynthesis and intramedullary nailing. Fixation with plates requires extensive dissection and is complicated by the proximity of the radial nerve and the risk of mechanical failure in osteopenia bones. Biomechanically intramedullary nail is a better implant. They are subjected to smaller bending loads and are less likely to fail by fatigue, they act as load sharing devices, stress shielding with resultant cortical osteopenia is minimum, refracture after implant removal is rare and they do not require extensive exposure
Methods: We have done a prospective study of 30 patients with Fracture shaft Humerus stabilized with intramedullary nail of Enders type by antegrade approach. These nails were available in 3 & 3.5 mm diameter and in lengths ranging from 18-28 Cms. The nail by design had proximal band of 6 degrees (apex medial band) to accommodate offset of the infusion portal with the medullary canal.
Results: Study shows more incidences of Humerus fractures in young patients as it is active age group in the society, more prone to vehicle accidents and falls. Most of the fracture of shaft humerus unites in 10-14 weeks and in minor cases more than 18 weeks were observed for union. Most common complication associated with operative method of fracture shaft humerus is non union. Joint involvement in form of shoulder or elbow stiffness can occur in small number of cases. There are no cases of infection noted in our study
Interpretation and Conclusion: Internal fixation by close intramedullary nail for fractures involving middle two third shaft of humerus is a good technique if facilities are provided for image internsifier machine in operation theater. In comparision to other operative techniques close intramedullary nailing is less invasive with minimal blood loss and hardly any chance of infection. This technique gives rotational as well as torsional stability to fractured bone humerus, allowing faster practice of physiotherapy to achieve full range of motion and power.
