Abstract
BACKGROUND: The best course of action for surgical intervention for humerus shaft fractures is up for dispute. Over the course of three years, a prospective, comparative study was conducted to compare the management of acute humeral shaft fractures treated with dynamic compression plating and antegrade interlocking nail fixation. After taking into account the inclusion and exclusion criteria, twenty patients with interlocking nailing and sixteen patients with plating were included. Postoperative assessment was conducted using functional scoring criteria, with an average follow-up time of one year. With the plating group in our series, there was a tendency for the earlier union and a larger percentage of outstanding and good results. Three percent of all fractures are humeral diaphyseal fractures. But conservative medicine has drawbacks of its own. Second, it can't be suggested in every situation.
AIM: The aim of this investigation was to evaluate the humeral nailing system according to clinical results, and to recognize the advantages and disadvantages of interlocking.
MATERIAL AND METHOD: The Department of Orthopedics was the site of the prospective observational study. As a result, thirty patients underwent surgery—fifteen under plating and fifteen under nailing. We employed the anterolateral approach in the supine position and the posterior approach in the lateral position during compression plating. The location and shape of the fracture will determine which method is best. Every patient had a 4.5 mm compression plate DCP, and lag screws were utilized for interfragmentary compression where necessary. Typically, a plate was utilized that allowed screw fixation to a minimum of six cortices in both the proximal and distal segments. Following the acquisition of signed informed permission, prospective patients were screened. Adult patients of both sexes who had a radiologically confirmed clinical diagnosis of a diaphyseal fracture of the humerus were included.
RESULTS: The patients in this study ranged in age from 19 to 69, with a mean age of 42.30. The majority of patients (24.66%) were in the 26–36 age group, with 21.33% coming from the 66–76 age range. Of the thirty patients, sixteen (60%) were men and fourteen (40%) were women. The highest percentage of cases experienced a minor fall or stumble (30.00%), followed by RTA (26.66%) and serious trauma (26.66%). Of the patients, 20% were unstable and 30% underwent surgery when polytrauma was discovered. Poor skin problems required surgery for four patients (13.3%). The percentage of obese patients was comparable. Two patients required intervention due to oblique fractures, even though 10% of patients had pendulous breasts.
CONCLUSION: Dynamic compression plating has proven to be a reliable technique for stabilizing humeral transverse diaphyseal fractures over time. Osteosynthesis is aided by the compression the plate creates at the fracture site. However, the method is not appropriate for fractures that are significantly closer or farther from the shaft, pathological fractures, comminuted fractures, segmental fractures, extensive osteoporosis, or non-union. With the advent of interlocking nailing, many of the issues with the conventional dynamic compression plating process have been resolved.
KEYWORDS: Dynamic Compression Plate, Fracture, Humerus and Interlocking Nail