Orthopedic & Muscular System: Current Research
Open Access

Abstract

Intramedullary Interlocking Nailing Versus Dynamic Compression Plating in Diaphyseal Humeral Fractures in Adults-A Comparative Study

Madhan Jeyaraman, Kartavya Chaudhari, Ajay SS3, Sabarish K, Likhith D

Introduction: The diaphyseal fractures of humerus account for 3% of all fractures. The management of diaphyseal humeral fractures remains controversial. The various studies proved the conservative management of these fractures were the gold standard which outweighs the risk-benefits associated with the operative procedures. To improve the functional quality of life, early return to sports and to avoid complications, the surgical management of these fractures are of prime importance. Objectives: To study the functional outcome of humerus diaphyseal fractures operated with intramedullary nailing and dynamic compression plating. Materials and Methods: From September 2015 to August 2018, a total of 107 patients were operated for diaphyseal humeral fractures in the department of Orthopedics, JJM Medical College, Davangere, Karnataka, India. These 107 patients were divided into two groups namely group N (n=59) were the patients who received intramedullary interlocking nailing for humeral diaphyseal fractures and group P (n=48) were the patients who received dynamic compression plating for humeral diaphyseal fractures. All the patients were functionally analyzed with DASH scores. Results: In our study, in group N (n=59), the range of movements according to DASH scores were excellent in 39 patients (66.10%), good in 15 patients (25.42%) and poor in 5 patients (8.47%) and in group P (n=48), the range of movements according to DASH scores were excellent in 23 patients (47.91%), good in 16 patients (33.33%) and poor in 9 patients (18.75%). In our study, group N patients experienced less complication than group P patients, as group P patients developed post-operative nerve palsy which seems to be grievous injury out of surgery. The correlation analysis with Spearman’s Rank correlation coefficient (rho ρ) was 0.79 for group N and 0.63 for group P between implants used and the union of humeral diaphyseal fractures. There is a statistically significant difference between union rate and complications between two groups with p<0.03. Conclusion: No specific implant is superior to treat shaft of humerus fractures. Due to improved technical advances, closed reduction and internal fixation with intramedullary interlocking nailing of shaft of humerus fractures serve the better implant of choice in terms of post-op complications and blood loss.

Published Date: 2019-07-25; Received Date: 2019-05-04