Comparative study of intramedullary nailing versus plating for shaft fractures of humerus in adults

Abstract

The present study was conducted from September 2017 to October 2019 over a period of two years consisting of 30 patients to compare the results in terms of functional outcome, rate of union and complications of plating versus nailing in treatment of diaphyseal fractures of humerus. 12 patients had undergone nailing and 18 patients had undergone plating. The youngest patient was 21 years old and eldest patient was 75 years old. Maximum number of patients belonged to the age group of 21 to 40 years (46.66%). Most of the patients were male (70%). Road traffic accident was the most common mode of injury (53.33%). Right sided injury was more than left. Majority of the patient's sustained closed injury (90%) compared to open injury (30%). A total of 3(10%) patients had 12A1 type, 5(16.66%) patients had 12A2 type, 8(26.66%) patients had 12A3 type, 7(23.33%) patients had 12B2 type, 5(16.66%) patients had 12B3 type and 2(6.66%) patients had 12C3 type. The minimum follow up among nailing patients were minimum of 10 months and maximum of 20 months with a mean of 16 months the minimum follow up was for 8 months and maximum of 20 months with a mean of 16 months. Two (6.66%) patients came with concomitant radial nerve palsy which was recovered completely within 6 months after surgery. The average time taken for union is 13.8 weeks and 15.1 weeks for nailing and plating respectively. There were 2 cases (16.66%) of delayed union among the nailing category and 4 cases (22.22%) of delayed union among the plating group. There were 2 case (11.11%) of non-union among the plating group and no non-union was seen among the nailing group. Functional outcome was assessed using DASH score analysis. The mean DASH score in nailing group is 30.20 and for plating group is 26.71which is a good functional outcome in both case. 2 (16.66%) patients had shoulder impingement among the nailing group. 1 (5.55%) patient had implant failure among the plating group. 2 (11.11%) patient among the nailing group had post op radial nerve palsy. 2 (11.11%) patients had superficial infection and 1 (5.55%) patient had deep infection among the plating group. There was no case of infection among the nailing group. 2 (11.11%) patents had non-union among the plating group.