Abstract: Background: The operative management of the fractures of shaft of humerus is most commonly accomplished with the help of Open Plate fixation or closed intramedullary interlocking Nails. Controversy exists so as to which modality is superior to the other. Hence the study was conducted with an aim to compare the functional outcome of humeral shaft fractures treated by two procedures - closed intramedullary interlocking nailing and open plate osteosynthesis.
Materials & Methods: This prospective observational study consisted of 32 participants who were recruited to both the study groups sequentially till the sample size was reached in each group. The participant allocation was done to either of the surgical procedures based on their preferences. Patients were evaluated both clinically and radiologically at the end of 1 month, 3 months, 6 months and 1 year from the day of surgery. Study group (Plating Vs Nail) was considered as a primary explanatory variable. Time to union, functional outcome as assessed by American shoulder and elbow society score were considered as primary outcome variables of interest. Need for bone grafting was considered as the secondary outcome variable.
Results: Both the study groups were comparable with respect to all the baseline variables. The proportion of subjects showing signs of the radiological union was 100% and 92.86% in plating and nailing group respectively. The proportion of subjects with radial nerve involvement was slightly higher in plating group, as compared to nailing group (12.5% vs 7.14%), but the difference was statistically not significant (P value=0.626). There was no statistically significant difference in the proportion of subjects needing bone grafting (18.75% in plating vs 14.29% in nailing group, P value 0.743). The meantime for union was slightly longer in plating group, as compared to nailing group (15.44 ± 2.39 vs 13.93 ± 1.85 Weeks, p value 0.067), which was statistically, not significant. The functional outcome at the end of follow up period as assessed by mean ASES score 26.44 ± 2.31 in plating vs 26.64 ± 1.65 in nailing group) was comparable between the two intervention groups.
Conclusions: The radilogical and funtional outcome following humeral shat fracture treatment with plate osteosynthesis and intramedullary nailing were comparable.
