Comparison of Humeral shaft fractures treated with interlocking nailing versus plating

Abstract

Introduction:

Plate osteosynthesis and interlocking humerus nailing are two commonly employed surgical techniques. Plate osteosynthesis offers stable fixation and is preferred for certain fracture patterns, while interlocking nailing provides rotational stability with minimal soft tissue disruption. This research aims to assess the outcomes of these surgical methods and their impact on functional recovery.

 Materials and Methods:

This prospective research has been performed at Saveetha Medical College included 30 patients with closed humeral shaft fractures. Patients aged under 18 and those with compound grade III fractures were excluded. Treatment decisions were based on clinical and radiological assessments, with only operative cases included in the study. Plate osteosynthesis and interlocking humerus nailing were performed based on fracture characteristics and patient factors. Follow-up evaluations were conducted over a period of 3-9 months, assessing fracture union, functional outcomes, and complications.

 Results:

Of the 30 patients included, the majority were in the 2nd and 3rd decades of life, with a male predominance (56%). Road traffic accidents were the leading cause of fractures (70%), with the right side being more commonly affected (53.33%). Plate osteosynthesis and interlocking nailing were performed in 15 patients each. Fractures predominantly occurred in the middle 1/3rd of the humeral shaft (73.33%).Union rates were high in both groups, with 80% achieving union in less than 16 weeks. However, in 20% of interlocking nailing cases, shoulder stiffness was noted, and in 6% of cases, the delayed union took place. Complications like radial nerve palsy and infection were more prevalent in the plating group, affecting 20% and 6% of cases, respectively.

 Conclusion:

The selection of the implant depends on factors like indications, patient preference, and the surgeon's choice. In well-evaluated patients with clear indications, either plating or nailing for internal fixation of these fractures may be considered optimal management. Both methods have their advantages and disadvantages.