Osteosynthesis in fractures of the distal third of humeral diaphysis.

ABSTRACT OBJECTIVES To compare the clinical results of osteosynthesis with plate and screws versus anterograde locked intramedullary nail in fractures of the distal third of humeral diaphysis. MATERIAL AND METHODS 184 patients with fractures of the distal third of humeral diaphysis were included in a prospective study. 82 patients underwent open reduction and internal fixation with plate and screws (Group 1), while in 102 cases, closed reduction and osteosynthesis with locked intramedullary nail was performed (Group 2). The 2 groups were similar in terms of age and gender distribution and pattern of fractures. The function of shoulder and elbow were assessed using the Oxford Shoulder Score (OSS) and Oxford Elbow Score (OES). Operating time, duration of hospital stay, complications and moment of union were recorded. OUTCOMES 6 months after surgery the average OSS was 44.42 in Group I and 40.23 in Group II, while the mean OES was 40.88 in Group I and 46.54 in Group II. The average duration of the surgical procedure was 87 min in Group1 and 43 min in the nail group (p<0.001).The mean duration of hospital stay was 2.6 days in Group 1 and 1.8 days in Group 2 (p<0.05). The rate of non-unions was 3.66% in the plate group and 2.94% in the retrograde nail group (p>0.05). CONCLUSIONS The clinical results of the 2 methods of osteosynthesis were similar, but the operating time and the duration of hospital stay were longer after plate osteosynthesis. Shoulder function was slightly impaired in the nail group but not statistically significant.