Key result
Intramedullary nailing significantly reduced operative time (82.1 vs 119.59 mins) and intraoperative blood loss compared to dynamic compression plating, while yielding similar functional outcomes.
Why the study?
There is constant debate regarding the best surgical technique for the fixation of shaft humerus fractures between intramedullary nailing and dynamic compression plating.
Does intramedullary nailing compared to dynamic compression plating improve functional outcomes or reduce complications in patients with shaft humerus fractures?
Observational (n=27)
No
Does intramedullary nailing compared to dynamic compression plating improve functional outcomes or reduce complications in patients with shaft humerus fractures?
Absolute Event Rate: 82.1% vs 119.59%
p-value: p=<0.05
Intramedullary nailing and dynamic compression plating yield similar functional outcomes for humeral shaft fractures, though nailing significantly reduces operative time and blood loss while presenting a different complication profile.
May favor intramedullary nailing for efficiency in fracture fixation; leaves open definitive recommendations pending randomized trials.
Introduction There is constant debate regarding the best surgical technique for the fixation of shaft humerus fractures. Intramedullary nailing and dynamic compression plating are the most popular surgical options. Materials and methods In our study, we retrospectively analyze the results of 27 patients with shaft humerus fractures managed with intramedullary nailing (10) and dynamic compression plating (17) at our institute from September 2021 to October 2022. Preoperative clinical assessment sheets, postoperative follow-up sheets, operative notes, anesthesia sheets, and preoperative and follow-up radiographs were analyzed. Reamed antegrade nailing was done in all cases, while dynamic compression plating was done through a posterior approach. Results The operative time of the nailing group was 82.1 ± 7.61 mins, which was significantly lesser (P value <0.05) than that of the plating group, which was 119.59 ± 10.16 mins. The intraoperative blood loss of the patients who were managed with nailing was 71 ± 7.38 mL, which was significantly lesser (P value <0.05) than that of the plating group, which was 130.59 ± 11.44 mL. The patients in both groups had a statistically nonsignificant difference in terms of functional results, which were assessed using Rodriguez-Merchan criteria. Complications were similar in both groups with infection (17.65%), and postoperative radial nerve palsy (11.76%) was more common among the patients undergoing plating, and shoulder impingement(20%) was common among those undergoing nailing. Conclusion This study concluded that both surgical options are similar in the case of functional results. The selection of the surgical method should be as per the surgeon's surgical familiarity and personalized to individual patients.
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Angachekar et al. (2024) conducted an observational in Shaft of humerus fractures (n=27). Intramedullary nailing vs. Dynamic compression plating was evaluated on Operative time (minutes) (p=<0.05). Intramedullary nailing significantly reduced operative time (82.1 vs 119.59 mins) and intraoperative blood loss compared to dynamic compression plating, while yielding similar functional outcomes.
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