“Comparative Study of Functional Outcome of Dynamic Compression Plating and Interlocking Nailing For Fracture Shaft of Humerus in Adults”

Background: 3% to 5% of all fractures are mid humeral shaft fracture and 2% to 10% are open fractures. The options available for mid shaft fractures are open reduction and internal fixation with plate , and closed reduction and fixation with interlocking nail and conservative. The treatment outcomes have been studied . Objective: In this study we compared the outcome of fracture fixation with dynamic compression plating and interlocking nailing. Materials and methods: Fourty adult patients with fracture shaft humerus attending to Jubilee Mission Medical College Hospital, Thrissur between January 2014 and January 2015 was evaluated pre-operatively and the functional results were assessed post-operatively.The patients were evaluated as per the history, mode of injury. Necessary radiological investigations and hematology profile was done on admission.Type of surgery and details was noted. The immediate post-operative x-ray was evaluated. All the cases were evaluated through clinical and radiological methods at weeks, 6weeks, 12weeks, 6months, 1year and in between if required Results: Forty two percent of cases were in the age group 31-40 years. The males outnumbered the females. The most common cause was motor vehicle accidents amounting to 64%. Right side was involved in 65% of all cases. All operations were done within 4-6 days of injury.In the twenty patients of plate group, the complications were: Infection-7.1%; delayed union-12%; movement restriction of shoulder-12%; movement restriction of elbow-7%. In the twenty patients of nail group, complications were: infection-6.7%; fracture end splintering-7.6%; delayed union-26.8%; movement restriction of elbow-7.6%; movement restriction of shoulder-14.3%; shoulder pain-48%. Maximum number of fractures (73.3% in plating group and 60% in nailing group) clinically united in 12 weeks but the results were statistically insignificant.Excellent results were obtained in 15 patients (73.3%) in locking plate group and 12 patients (60%) in locking nail group on functional assessment. Conclusion: Both locking plating and interlocking intramedullary nailing provided statistically comparable results for patients requiring surgical treatment of mid shaft humeral fractures.But ,a higher rate of excellent and good results and a tendency for earlier union was seen with locking plating group in our study.