Comparison of radiological and functional outcome in patients with fracture shaft of humerus treated with interlocking nailing and with plate osteosynthesis: A Prospective study

Ganesh Anand Kumar, T (2011) Comparison of radiological and functional outcome in patients with fracture shaft of humerus treated with interlocking nailing and with plate osteosynthesis: A Prospective study. Masters thesis, Kilpauk Medical College, Chennai.


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INTRODUCTION: Fracture of the shaft of the humerus represents 3 to 5 % of all fractures. Current research in this area focuses on defining the incidence and health care resources needed to treat these fractures, refining the indications for surgical intervention, decreasing the surgical failure rate through new implants and techniques, and minimizing the duration and magnitude of disability post injury. The successful treatment does not end with bony union but the current emphasis is on a holistic approach of patient care. The treatment of the humeral shaft fractures demands a knowledge of anatomy, surgical indications, techniques and implants, and patient function and expectations. The goal of operative treatment of humeral shaft fractures is to re-establish length, alignment and rotation with stable fixation that allows early motion and ideally early weight bearing on the fractured extremity. The Plate osteosynthesis remains the gold standard of fixation of humeral shaft fractures against which other methods can be compared. Although it has high union rate, it involves extensive dissection and soft tissue stripping, chance of injury to radial nerve and infection is present. The Intramedullary interlocking nailing has the advantage of minimal surgical exposure and soft tissue dissection, with stable fixation and rotational control. It can be done antegrade or retrograde manner. AIM: The aim of this study is to compare the Radiological and Functional outcome in patients with fracture shaft of the humerus treated with Dynamic Compression plating and those treated with Intramedullary Interlocking nailing. MATERIALS AND METHODS: This is a prospective comparative study of 22 patients with humeral shaft fractures treated with Intramedullary interlocking nailing and Plate osteosynthesis done in the Department of Orthopaedics,Government Kilpauk Medical College Hospital from April 2009 to May 2010. Inclusion Criteria - • Acute fractures of humeral shaft, • Patients aged above 18 years, • Fractures 2cm below surgical neck and 3 cm above olecranon fossa, • Multiple injuries, • Neurovascular involvement, • Osteoporotic bone, • Angulation more than 15 degrees, • Non compliance in conservative treatment. Exclusion Criteria - • Open physis, • Age less than 18 years, • Fractures involving proximal 2 cms and distal 3 cms of the humeral Diaphysis. RESULTS: Majority of the patients taken for the study both in the Interlocking nailing group and in the Plating group are in the age group of 21 to 40 years (60 – 70%). Majority of the patients in the study who sustained fracture shaft of humerus are males both in the interlocking nailing and in the plating group. The mode of injury in most of the cases in both the groups are due to Road Traffic Accidents (70% in IL nailing group and 67% in Plating group).The remaining are due to fall and due to assault. 50 – 60 % of the patients in the study have involvement of the dominant side in both groups. The most common type of fracture in our study in both the groups according to AO classification is Type A. The next type in frequency is Type B. CONCLUSION: In our study, there is no significant difference in the period of union of fractures after both the methods . The chance of infection is more in the Plating group than in patients treated with Closed reduction and Interlocking Nailing patients. The Restriction of shoulder movements are seen in patients in the Nailing group possible due to Prominent nail tip at the entry site and also due to violation of the Rotator Cuff . Non union can occur due to distraction of the fracture site while Nailing.

Item Type: Thesis (Masters)
Uncontrolled Keywords: radiological and functional outcome ; patients ; fracture shaft of humerus treatement ; interlocking nailing ; plate osteosynthesis ; prospective study.
Subjects: MEDICAL > Orthopaedics
Depositing User: Subramani R
Date Deposited: 16 Sep 2017 18:31
Last Modified: 17 Sep 2017 17:27

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