ABSTRACT
Aim: This study aimed to compare the outcomes of the humerus diaphyseal fractures which is treated with a dynamic compression plate (DCP) and the intra-medullary nail (IMN).
Methods: The 47 patients who had diaphyseal fractures of humeral shaft had been treated with the reduction openly and fixation internally with either IMN or DCP after being randomised prospectively. The following criteria had to be met for a patient to be included: unstable fractures, polytrauma, compound fractures of grade I or IIa, and on time failure of the treatment conservatively. The study excluded the patients with the fractures pathologically, open fractures of grade III, refractures, and previous, untreated humerus fractures. Internal fixation was performed on 23 patients using IMN and 24 using DCP. All cases involved reaming antegrade nailing. Anterolateral or posterior approaches were used for DCP. The outcome was evaluated based on the time of union, rate of union, the functional outcome, and the incidence of complication. Utilizing the ASES (American Shoulder and Elbow Surgeons’) Score, functional outcome was evaluated.
Results: There is nope discernible alteration in the ASES scores amongst the two groups when results of the independent samples t test were compared (P>0.05). When comparing IMN with DCP, it was discovered that the average union time was substantially shorter for IMN (P<0.05). Both groups’ unionisation rates were discovered to be comparable. Infection-related complications were shown to be more common with DCP than IMN, although arm shortening (1.5–4 cm) and shoulder mobility restrictions because of nail impingement were found to be more common with IMN than DCP.
Conclusion: However, after the nail was taken out and the fracture had healed, this got better for everyone. This study demonstrates that IMN gives a quicker time of union and a low risk of significant consequences like the infection, making it surgically better choice for treatment of the fractures of humeral diaphyseal. Regarding rate of union and functional outcome, there doesn’t seem to be any distinction between the two groups.
Keywords: Dynamic Compression Plate, fracture, DCP, intra-medullary nail, fracture of humerus