Treatment of Humeral Shaft Fractures in adults by Intramedullary Nailing Versus Plating

Abstract

Background:Fractures of the shaft of the humerus is about 3%-5% of all fractures in adults. The plate may fail in osteoporotic bone and the intramedullary nailing included less invasive surgery and use of a load sharing device support.This study is aimed to compare the interlocking intramedullary nailingoutcome versus plating of diaphyseal humeral shaft fractureoutcome in adults. Patients and Methods:A prospective clinical trial was carried in Orthopedic Department, Zagazig University in Egypt Hospitals and Alwahda Hospital in Libya, on 36 cases with Humeral shaft fractures in adult with age between 21year to 54year.Patients were followed post operatively for union, and clinical assessment was done using ASES scoring system including; shoulder function, elbow function, union and pain.Results:Operation time was distributed as 134.44±23.52 and 155.54±22.85 respectively between nail and plate groups and nail group was significantly shorterUnion time was shorter in plate group but not significantly as it was distributed as 14.64±3.99 and 13.26±3.97 respect, nonunion and mail union was higher in nail group compared to plate group with no significant difference P>0.05. There was no significant difference between group as regard pain.Comparison between outcomes of different management in both groups showedwith no significant difference P>0.05. Conclusion: Midshaft fractures humerus in adults could be fixed by either intramedullary nailing or plating. However plating associated with more blood loss and higher infection rate and intramedullary nail fixation for humerus associated with more higher incidence of shoulder discomfort, and more malunion and non unuon rate.