Evaluation of the Functional Outcome of Intramedullary Interlocking Nail Fixations for Humeral Shaft Fractures

Abstract

Background And Objective: Humeral shaft fractures are commonly treated by orthopaedic surgeons and account for approximately 3% of all fractures. Antegrade interlocked humerus nailing for stabilisation of humerus fractures was introduced many years ago and is a valid treatment option for stabilising the shaft of humerus fractures. As complications, such as non-union, malunion, fracture disease, and difculty in nursing and rehabilitation in polytrauma cases, are less likely with this procedure, intramedullary interlocking (IMIL) nailing successfully bridges the gap between functional bracing and plating. The scoring system of the University of California Los Angeles (UCLA) is used to assess the functional outcome of intramedullary interlocking nailing for humerus shaft fractures and any associated complications of the above-mentioned procedure. Method: Thirty patients between the ages of 18 and 65 who were admitted to the orthopaedics department in R.L. Jalappa Hospital, part of the Sri Devaraj Urs Medical College, with a fracture of the humerus shaft and met the inclusion and exclusion criteria were included in the study. Their demographic data, history, clinical examination, and details of investigations were recorded in study proforma, and they were then taken for anterograde IMIL nailing. The recovery and ambulation time as well as complications of the procedure, such as pain, infection, joint stiffness, iatrogenic fractures, and radial nerve palsy, were documented, and the patients were followed up with one, three, and six months after surgery. Result: Among the 30 patients treated with IMIL nailing, the complications were as follows: Two patients showed shoulder stiffness and delayed union, one patient had a surgical site infection and shoulder stiffness, one patient had only shoulder stiffness, one patient had an iatrogenic fracture of the lateral epicondyle of the humerus, and one patient had implant breakage secondary to trauma after xation. Functional outcomes were evaluated using the UCLA scoring, in which 24 (80%) patients had a good outcome regarding pain relief, 24 (80%) had an excellent functional outcome, and 24 (80%) patients had excellent post-surgery muscle power and motion at their six-month follow-up. Intramedullary Conclusion: interlocking nailing is a safe and effective treatment modality for humeral shaft fractures with an excellent functional outcome. This is shown by a mean UCLA score of 31.73 ± 3.609 at follow-ups six months after surgery. In addition, IMIL nailing is associated with a low incidence of complications, with the most likely complication being shoulder stiffness