A Hospital Based Prospective Study to Evaluate the Comparison of Radiological and Functional Outcome in Patients with Fracture Shaft of Humerus Treated with Interlocking Nailing and with Plate Osteosynthesis at Newly Established Tertiary Care Centre

Abstract

Background: Intramedullary nailing is considered as gold standard in treatment in fracture of femoral and tibial shaft fractures. But there is no agreement about the ideal treatment for fractures of humeral shaft. The aim of this study is to compare the Radiological and Functional outcome in patients with fracture shaft of the humerus treated with Dynamic Compression plating and those treated with Intramedullary Interlocking nailing. Materials & Methods: This is a prospective comparative study of 20 patients with humeral shaft fractures treated with Intramedullary interlocking nailing and Plate osteosynthesis done in the Department of Orthopaedics, Newly established Government Medical College, Dungarpur, Rajasthan, India during one year period.Wound inspection done on 2nd post op day. Suture removal done on 12th day. Active shoulder and elbow started on 3rdin nailing procedure and 5th to 6th day in compression plate once the pain level decreases under physiotherapist guidance and tolerability of the patient. Results: The average age of patients was 46 years in both groups. Mostly patients were males (75%) in both groups. The mode of injury in most of the cases in both the groups are due to Road Traffic Accidents (70% in IL nailing group and 80% in Plating group).The remaining are due to fall and due to assault. 60–80 % of the patients in the study have involvement of the dominant side in both groups. Average time of union in INL group was22 weeks & 20 weeks in DCP group. The functional Range of Movements in shoulder joint after Nailing is excellent and good in 90% of patients and fair in 1 patient (10%) &elbow function recovered in almost all patients with 90% excellent result and 10 % has good recovery in INL group. All patients treated with Plate Osteosynthesis had excellent to good functional outcome in elbow, 90% of cases have excellent and good results in shoulder function and 1 case had fair result. Conclusion: We concluded that patients can be treated with dynamic compression plating andinterlocking nailing for fracture of shaft of humerus. Intramedullary interlocking nailing is an effective and safe alternative for treatment of diaphyseal fractures of humerus. It is suitable for patients with osteoporosis, polytrauma and in segmental fractures.