Antegrade Interlocking Nailing versus Dynamic Compression Plating for Humeral Shaft Fractures

Kulkarni, Shreyas; Varshneya, Ankit; Jain, Mohit; Kulkarni, Vidhisha S; Kulkarni, Govind S; Kulkarni, Milind G; Kulkarni, Ruta M

doi:10.1177/230949901202000304

Cited by 16 publications

(19 citation statements)

References 22 publications

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“…13 Implant failure in plating may be explained by the stress rising at the end of the plate, 7 as well as the stress shielding of the bone by the plate at the fracture site which reduces the strength of the union and, it also provides less secure fixation especially in the osteopenic bone. 15 In the present study, a higher rate of reoperation was observed in plating group without a significant difference. This result was unlike the study conducted by Kumar et al, 1 where IMN had an increased rate of reoperations, also without a statistically significant difference.…”

Section: Discussionsupporting

confidence: 41%

“…Kulkarni et al concluded that the overall complication rate was higher in the IMN group without a significant difference in their study. 15 But, overall significantly higher total complication rate in the plating group was observed in this study.…”

Section: Discussionmentioning

confidence: 45%

“…Fixation with IMN is a much simpler technique than plating as there was minimal exposure 14 , which results in shorter operative time and less intraoperative blood loss. 15 Due to its minimal invasive procedure and its simpler technique, the length of hospital stay after definitive management in IMN group was also significantly shorter than in the plating group. 9 A similar result was established in this study.…”

Section: Discussionmentioning

confidence: 89%

“…6 Iatrogenic radial nerve palsy was higher with 2/28 cases (7.1%) in the plating group and 0/26 in the IMN group in this study, with an insignificant difference as in the previous study. 15 Those two cases were managed conservatively and recovered well in a mean time of two months indicating a neuropraxic type of injury.…”

Section: Discussionmentioning

confidence: 96%

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Outcome of Humeral Shaft Fracture Treated with Intramedullary Nail and Plate Fixation

Wang¹,

Kayastha²,

Cao³

et al. 2020

J Coll Physicians Surg Pak

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Section: Discussionsupporting

confidence: 41%

Section: Discussionmentioning

confidence: 45%

Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 96%

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Outcome of Humeral Shaft Fracture Treated with Intramedullary Nail and Plate Fixation

Wang¹,

Kayastha²,

Cao³

et al. 2020

J Coll Physicians Surg Pak

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“…The most commonly used techniques are: osteosynthesis with plate and screws (LCP, locking compression plate) [5], the splint with intramedullary nail (IMN), and the external fixation (EF) [6]. These techniques have different biomechanical and physiological aspects, each with their advantages and disadvantages [7-12].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Plate, Nail and External Fixation in the Management of Diaphyseal Fractures of the Humerus

et al. 2017

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Introduction:Humeral shaft fractures are quite common in orthopedics and represent 1-3% of adult fractures. The surgical treatment is the a better choice in order to obtain a reduction and stable alignment and to prevent the complications. The goal of this study was to compare the three techniques (IMN, LCP and EF) in the treatment of diaphyseal fractures of the humerus in the adult patient.Materials and Methods:We examined 79 patients with diaphyseal fractures of the humerus. 32 were treated with plaque (LCP), 26 with intramedullary nail (IMN) and 21 with eternal fixer (FE) The clinical and radiographic follow-up was done at 1.3, 6 and 12 months. As rating scales we used the ASES and SF-36. We recorded all the complications.Results:The median follow-up was 11.5 months (9-16). The operative time was significantly smaller in the case of FE (47 ‘) with a statistically significant difference compared with other techniques. Even the blood loss was lower in the case of FE (60ml), compared to nails (160ml) and LCP (330ml) p <0.05. We had no differences in the duration of hospitalization and the ASES SF-36 score. We had 2 cases of non-union in the LCP group, 1 case in the IMN group and no cases in the FE group. In IMN group we had one case of radial transient paralysis. We did not have any deep infection, in the FE group 8 patients we had superficial secretions from pins.Conclusion:From the results of our study, it is clear that the treatment of humeral shaft fractures guarantee overlapping results with the use of plates, of intramedullary nails, or with the external fixator. Consequently, the choice of which technique to use should be determined based on the experience of the operator and patient compliance.

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Open plate fixation versus nailing for humeral shaft fractures: a meta-analysis and systematic review of randomised clinical trials and observational studies

Beeres

Veelen

Houwert

et al. 2021

Eur J Trauma Emerg Surg

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Purpose This meta-analysis compares open reduction and internal fixation with a plate (ORIF) versus nailing for humeral shaft fractures with regard to union, complications, general quality of life and shoulder/elbow function. Methods PubMed/Medline/Embase/CENTRAL/CINAHL was searched for observational studies and randomised clinical trials (RCT). Effect estimates were pooled across studies using random effects models. Results were presented as weighted odds ratio (OR) or risk difference (RD) with corresponding 95% confidence interval (95% CI). Subgroup analysis was performed stratified for study design (RCTs and observational studies). Results Eighteen observational studies (4906 patients) and ten RCT's (525 patients) were included. The pooled effect estimates of observational studies were similar to those obtained from RCT's. More patients treated with nailing required re-intervention (RD 2%; OR 2.0, 95% CI 1.0-3.8) with shoulder impingement being the most predominant indication (17%). Temporary radial nerve palsy secondary to operation occurred less frequently in the nailing group (RD 2%; OR 0.4, 95% CI 0.3-0.6). Notably, all but one of the radial nerve palsies resolved spontaneously in each groups. Nailing leads to a faster time to union (mean difference − 1.9 weeks, 95% CI − 2.9 to − 0.9), lower infection rate (RD 2%; OR 0.5, 95% CI 0.3-0.7) and shorter operation duration (mean difference − 26 min, 95% CI − 37 to − 14). No differences were found regarding nonunion, general quality of life, functional shoulder scores, and total upper extremity scores. Conclusion Nailing carries a lower risk of infection, postoperative radial nerve palsy, has a shorter operation duration and possibly a shorter time to union. Shoulder impingement requiring re-intervention, however, is an inherent disadvantage of nail fixation. Notably, absolute differences are small and almost all patients with radial nerve palsy recovered spontaneously. Satisfactory results can be achieved with both treatment modalities.

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Antegrade Interlocking Nailing versus Dynamic Compression Plating for Humeral Shaft Fractures

Abstract: Both techniques were appropriate for treating humeral shaft fractures.

Cited by 16 publications

References 22 publications

Outcome of Humeral Shaft Fracture Treated with Intramedullary Nail and Plate Fixation

Outcome of Humeral Shaft Fracture Treated with Intramedullary Nail and Plate Fixation

Comparison of Plate, Nail and External Fixation in the Management of Diaphyseal Fractures of the Humerus

Open plate fixation versus nailing for humeral shaft fractures: a meta-analysis and systematic review of randomised clinical trials and observational studies

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