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Category: Volume 10 Issue 01 January 2022
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Title: Comparative Study of Functional Outcome of Dynamic Compression Plating With Interlocking Nailing For Fracture Shaft of Humerus in Adult

Authors: Dr Himanshu Hemant, Dr Rajesh Kumar

 DOI: https://dx.doi.org/10.18535/jmscr/v10i1.16

Abstract

Introduction: Humerus fracture is a common but difficult to manage in orthopedics. These are usually managed non-operatively (with a hanging arm cast, U cast or a U slab) unless complicated. Fractures of the shaft of the humerus account for around 1% to 2% of all bone fractures, and 14 % of humeral fractures.[5] The majority of humeral fractures do not require surgery and can be managed with a functional orthosis. The purpose of this study is to compare the outcomes of dynamic compression plating with interlocking nailing for the fracture shaft of humerus and to analyse statistically significant difference in the results of these two methods.

Method: The study was prospective, randomize, comparative study. In which 30 patients were divided into two groups. Group 1- Plating (open reduction and internal fixation with dynamic compression plating and Group 2- Intra medullary nailing (closed reduction and inernal fixation with antigrade intramedullary interlocking nail) for surgical management of fracture of humerus diaphysis and to find the functional outcome between dynamic compression plating (DCP) and intramedullary interlocking nailing in diaphysis fracture of humerus in adult.

Result: In the present study it is observed that the DCP group takes less time for union (p= 0.013) as compare to interlocking group. In DCP group- excellent cases were 73.03%, good cases- 13.3%,  fair and poor were 6.7%. In interlocking nailing group excellent cases were- 46.7%, good cases- 26.7%, fair cases- 16.6% and poor was 10% and the p value= 0.03. post operative complication like impingement and shoulder pain were more common in interlocking nailing and implant failure (6.7%) was found in DCP.

Conclusion: We conclude that antegrade intramedullary interlocking nails are better for transverse humerus shaft fractures, while plating is preferable for comminuted humerus shaft fractures and instances with accompanying neuro-vascular or soft tissue injuries. There is no one fixing mechanism that is preferable in all conditions for acute diaphyseal fractures, thus each patient must be treated individually. Although there appears to be significant difference in radiological union or rate of union between the two groups, plating of humerus shaft fractures is a favorable fixation approach based on complications reported and functional outcomes noted.

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Corresponding Author

Dr Himanshu Hemant

Junior Resident, Department of Orthopaedics, KMC, Katihar