Comparative Study between Use of Interlock Nailing and Dynamic Compression Plate for the Management of Diaphyseal Fracture of Humerus
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2018, Vol 6, Issue 1
Abstract
Introduction: Fractures of the humeral shaft are commonly encountered by the orthopedic surgeons. This study compares the functional outcome and radiological union in diaphyseal fractures of shaft humerus by intramedullary interlock nailing versus dynamic compression plate fixation. Methods: This study was conducted during the period between November 2015 and July 2017 on 30 patients having diaphyseal fractures shaft humerus with a minimum follow-up of 6 months. Of these, 15 cases in Group A underwent dynamic compression plating and 15 cases in Group B underwent interlock nailing. Interlock nailing was done by antegrade approach, and plating was done either by anterolateral or posterior approach. Patients were assessed functionally by the American Shoulder and Elbow Surgeons (ASES) score and Rodriguez–Merchan criteria and radiologically by union time. Result: At 6 months’ follow-up, we found that the mean ASES score in Group A was 45.07 with standard deviation (SD) of 2.28 and in Group B was 44 with SD of 2.54. P value was not statistically significant (P > 0.05). According to Rodriguez–Merchan criteria, the difference between the two groups was also not statistically significant (P < 0.05). Patients in interlock nailing group had shorter operative time and hospital stay, and there was no statistically significant difference in terms of time of the union of fractures. Both the groups had one case (6.66%) of superficial infection at the surgical site. There were one case (6.66%) in Group A and 3 cases (20%) in Group B who developed shoulder stiffness post-operatively. Conclusion: Internal fixation with dynamic compression plate may result in a better fracture reduction but has increased risk radial nerve lesion and infection. Intramedullary interlock nailing is an effective alternative to dynamic compression plating as it has comparable results in terms of functional score, union time, and complications. No single treatment is superior in all circumstances for a particular fracture, and each case has to be individualized.
Authors and Affiliations
Sam Singh, Sanjay Gupta, S K Kaushik
Keywords
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