Locked Compression Plating Versus Intramedullary Interlocking Nailing In The Management Of Diaphyseal Humerus Fracture - Randomized Control Trail
Journal Title: International Journal of Orthopaedics Traumatology & Surgical Sciences - Year 2016, Vol 2, Issue 1
Abstract
With the recognition of the role of vascularity and soft tissue in fracture healing, Locking Compression Plates were developed. LCP leave minimal footprints on the surface of bone in comparison to conventional plates. The use of Intramedullary locking nails has recently gained momentum after their dramatic success in fixation of lower limb fractures. There are very few studies comparing these two newer methods of fixation. This prospective, randomized study compares these two fixation methods. 57 patients in IMN group were compared with 51 patients in LCP group. Both groups were comparable in term of age, gender, duration of injury, site and comminution at fracture site. Patients were evaluated for intraoperative blood loss, surgery time, radiation exposure, post-operative radial nerve palsy, duration of post operative stay, infection rate, reoperation rate and union time during follow up. At each follow up, sign of union were assessed. Functional evaluation was done at 1 year with ASES and RM score. IMN group showed significantly better results in term of intra-operative blood loss and less post operative hospital stay. The less operative time and an earlier tendency towards union were also seen in IMN group although not statistically significant. Fewer complications in term of infection and radial nerve palsy in IMN group seen. The final union rates were same in both groups. Although shoulder stiffness remained a concern in nailing group, functional evaluation at 1 year showed nailing to be superior to plate fixation group. With the use of LCP reoperation rate was also comparable in both groups. With more and more patients demanding for minimally invasive surgeries, nailing can be a preferred method for fixation of diaphyseal fractures of the humerus.
Authors and Affiliations
SPS Gill, ankit mittal, sunil kumar, Manish Raj, Pulkesh Singh, javed Ali
Keywords
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