Outcome of Dynamic Compression Plate versus Interlock Intramedullary Nail for Management of Humeral Shaft Fractures

Abstract

Objective: To compare outcomes of interlock intramedullary nails with Dynamic compression plates for the treatment of humerus shaft fractures in terms of hospital stay time and shoulder Impingement. Subjects and Methods: In this comparative study, a total number of 74 patients having age 20-60 years who presented with closed and open Gustilo type I or II in middle third of humerus were included. Study was conducted in Islam hospital Sialkot and and Rajib Tayyip Erdogan Hospital, Muzaffargarh from June-2019 to June-2020. Group A (n=37) patients underwent dynamic compression plating (DCP) for treatment of fractures and group B (n=37) underwent interlocking intramedullary nailing (ILN) for humerus shaft fractures. We noted post-operative hospital stay, shoulder impingement and bone union rate in all patients. Results: The mean of patients included in this study was 42.45 (SD 9.89) years. There were 57 (77.03%) males and 17 (22.97%) females. The mean duration of fracture at the time of surgery was 39.98±7.23 days. Mean hospital stay was 4.72±1.23 days in in group A and 4.89±1.40 days in group B (p-value 0.60). There were 4 (10.8%) patients in group B in whom shoulder impingement occurred but there was no patient in group A with shoulder impingement (p-value 0.04). Complete union occurred in 35 (94.6%) patients in DCP group and in 34 (91.8%) patients in ILN group (p-value 0.64). Conclusion: Both DCP and ILN are associated with high bone union rates. The complications rate of ILN is higher in comparison to DCP group. Keywords: Humerus shaft fractures, dynamic compression plates, interlocking intramedullary nailing.

An Observational Study on the Functional Outcomes of Intramedullary Nailing Versus Dynamic Compression Plating for Humeral Shaft Fractures

“…Out of 30 patients in the nail group, the following problems occurred: shoulder discomfort (46.6%), elbow pain (6.6%), infection (6.6%), delayed union (26.6%), shoulder mobility limitation (13.3%), and splintering of the fracture end (6.6%). In the research by Joly A et al, the overall complication rate was 40% in the nailing group and 30% in the plating group (8) . Infections on the skin's surface occurred in 10% and 6.7% of cases, respectively, whereas non-union occurred in 6.7% and 3.3% of cases in the nailing and plating groups.…”

“…There was no difference in the study groups among the 60 cases, which were equally divided between 65% females and 35% men (p-0.103). In their study, Joly A et al found that the mean age of patients in the nailing and plating groups was 45.3 and 49.5 years, respectively, with a male majority in both groups (55% vs. 45) (8) .…”