Management of Humeral Shaft Fractures With Intramedullary Interlocking Nail Versus Locking Compression Plate

Fan, Yu; Li, Yue Wang; Zhang, Hong Bo; Liu, Jian Fei; Han, Xiang; Chang, Xiao; Weng, Xisheng; Lin, Jianhao; Zhang, Bao Zhong

doi:10.3928/01477447-20150902-62

Cited by 66 publications

(56 citation statements)

References 35 publications

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“…4 We also report interlocking nailing is superior to plating as nailing has higher rate of union and earlier union with lower incidence of complications in comparison to the conventional plate osteosynthesis for diaphyseal fractures of humerus. Various studies have reported different outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…10 Comparative studies of plate osteosynthesis versus intramedullary nailing in fractures of shaft of humerus have reported contradictory conclusions. 1,3,4,6,8,11,12 The purpose of this study was to compare nailing and plating in humeral shaft fractures with regard to union rate, time taken for fracture union, functional outcome and incidence of complications.…”

Section: Introductionmentioning

confidence: 99%

“…3,4 General accepted non operative treatment protocol of humeral shaft fractures includes 7 -10 days of sling and swathe, U-slab or hanging cast followed by functional bracing till fracture union. Non operative management often has good functional results, but prolonged immobilization, malunion, delay in return to pre-injury activities, shoulder and elbow stiffness are a matter of concern.…”

Section: Introductionmentioning

confidence: 99%

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Comparative study of operative management of humeral shaft fractures by dynamic compression plating versus locked intra-medullary nailing

et al. 2017

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Background: Operative management of humeral shaft fractures is mostly accomplished by surface plating or intra-medullary nail osteosynthesis. Both the treatment options have been variably reported to give good rates of union and functional outcome. We compared both the options to know the better one in multitude of variables.Methods: Thirty patients with fracture shaft of humerus were followed up for a period of 12 to18 months. 15 patients each underwent open reduction and internal fixation with dynamic compression plate and closed antegrade locked intra-medullary nailing. All patients were clinically and radiologically assessed till fracture union.Results: Diaphyseal humeral fractures in all the patients treated with nailing united and had a tendency to unite early compared to plating. Shoulder pain was initially complained by 2 patients from the nailing group and got subsided later on. The incidence of complications was more in the plate osteosynthesis group. Conclusions: In our study Intra-medullary nailing turned out to be superior to plating for amenable diaphyseal fractures of humerus in terms of higher rate of union, early union and lesser complications.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparative study of operative management of humeral shaft fractures by dynamic compression plating versus locked intra-medullary nailing

et al. 2017

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“…This result is comparable to the union rate achieved by Crates (94.5%), Fan (96.7%), Chapman (87%), Tsourvakas, (95.8%), Petsatodes (92.3%). 6,13,18,22,23 Reported nonunion rate in recent literature is 0-8%. 17 In our series, 2 patients had non-union.…”

Section: Discussionmentioning

confidence: 99%

“…Recently many authors in prospective randomized studies, comparing IMN versus locking compression plates in treatment of humeral Shaft Fracture found intraoperative blood loss, operative time, hospital stay and average union time) were significantly lower in patients treated with IMN and no significant difference between the two groups in terms of union rate, shoulder function or complications. [13][14][15][16][17] Shoulder pain and restriction of shoulder movements and risk of delayed union have been suggested as disadvantages of antegrade intramedullary fixation. [18][19][20] Impairment of shoulder function with antegrade IMN could be due to rotator cuff violation, and subacromial impingement.…”

Section: Discussionmentioning

confidence: 99%

Functional outcome of antegrade interlocking intramedullary nailing for humeral shaft fractures

et al. 2017

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INTRODUCTIONThe humeral shaft cylindrical in shape, the expanse between the proximal insertion of the pectoralis major and the distal metaphyseal flare of the humerus, adds resistance to both torsional and bending forces and provides strength. Adequate soft tissue envelope favors good prognosis in healing of uncomplicated fractures.Humeral shaft fractures account for approximately 1-3% of all fractures and 20% of humeral fractures with a bimodal distribution with peaks in young male patients, 21-30 years of age, and a larger peak in older females from 60-80 years of age.1 Most humeral diaphysis fractures are simple patterns of the mid-diaphysis These fractures have potential to cause significant disability in the young which is often temporary and in the old often permanent disability.Plating or intramedullary nailing are the main surgical options available for the definitive primary management of closed humeral shaft fractures and have their respective proponents with no consensus. ABSTRACT Background: Humeral shaft fractures which account for approximately 1-3% of all fractures and 20% of humeral fractures have potential to cause significant disability in the young which is often temporary and in the old often permanent disability. The use of locked intramedullary nailing for the treatment of humeral shaft fractures is gaining popularity because of its biomechanical and biological advantages. Methods: We present a descriptive retrospective review of 20 consecutive patients with acute humeral shaft fractures treated using an antegrade interlocking nail. Fracture union, functional outcome measured with Constant-Murley shoulder score and American shoulder and elbow surgeons (ASES) shoulder score and complications were assessed. Results: Patient age ranged from 20 to 74 years (average, 36 years) and average follow-up was 30.7 months (range, 12-48 months). There were 13 male patients and 7 female patients. Fracture of the middle third was most common accounting to 80% (16/20) of the fractures. Fracture union was achieved in 90% (18/20) of our cases. 2 patients had nonunion for which secondary surgeries were needed. According to Constant-Murley score, shoulder function was excellent in 70% (14/20) and good in 25% (5/20). Average ASES score was 93.3%. None of the patients had radial nerve palsy postoperatively. Conclusions: Gentle progressive reaming, correct entry point, minimal damage to rotator cuff, properly embedding the tip of the nail, good apposition of fracture fragments, static locking will help make antegrade intramedullary nailing, a dependable solution for the treatment of humeral shaft fractures and in achieving successful union with preserved/good shoulder and elbow function.

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Humeral Shaft Fractures

Hak

Mauffrey

2021

Evidence‐Based Orthopedics

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Management of Humeral Shaft Fractures With Intramedullary Interlocking Nail Versus Locking Compression Plate

Cited by 66 publications

References 35 publications

Comparative study of operative management of humeral shaft fractures by dynamic compression plating versus locked intra-medullary nailing

Comparative study of operative management of humeral shaft fractures by dynamic compression plating versus locked intra-medullary nailing

Functional outcome of antegrade interlocking intramedullary nailing for humeral shaft fractures

Humeral Shaft Fractures

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