Nagesh R. Desai1, Sandip Patil2, Ram Jethmalani3, Ravindra B. Gunaki4, Nirav S. Patel5, MandarShaha6, Himanshu G. Kulkarni7
INTRODUCTION: Optimal method of humeral shaft fracture fixation remains in debate till date. Two techniques under study include intramedullary nailing and dynamic compression plate fixation. Plating provides satisfactory results but requires extensive dissection and meticulous radial nerve protection. Theoretical advantage of intramedullary nailing included less invasive surgery, undisturbed fracture hematoma and use of load sharing device support. Purpose of this study is to compare outcomes of each method of fixation for fracture shaft of humerus.
MATERIALS AND METHODS: Patients with diaphyseal fractures of the humerus were divided in two groups of 20 treated with dynamic compression plate or with intramedullary interlocking nail. Postoperatively both groups received same type of physiotherapy. They were followed up regularly. Time taken for radiological union in two groups was compared. After satisfactory radiological union, functional outcome was assessed by “Disabilities of Hand, Shoulder and Elbow (DASH) Questionnaire”.
RESULTS: Functional outcome was better in DCP group compared to interlocking nailing group which was statistically significant (P= 0.062). Rate of healing was marginally better in DCP group as compared to I.M nail.
CONCLUSION: We are of opinion that when surgery is opted as a choice of treatment, both modalities of treatment i.e. dynamic compression plating and interlocking nailing are good as far as union of fracture is concerned, but considering number of complications and functional outcome, we opine that dynamic compression plating offers better result than antegrade interlocking nailing with respect to pain and function of shoulder joint.
