Abstract

The aim of the present study was to assess the management with interlocked nail in treatment of acute fracture shaft humerus and to compare its effectiveness with well-established method of plate fixation. Methods: The present study of management of acute humeral shaft fractures by antegrade interlocking nail fixation and dynamic compression plating was undertaken in the Department of Orthopaedic for the period of 2 years. The average follow-up period was one year (range 10-24 months). 100 patients were included in the study. Results: There was preponderance of male over female with majority population in 31-40 years age group. The youngest patient was of 28 years and oldest was of 65 years male. Mean age was 38.62 years. In our study, majority of cases were of road traffic accident (85%) followed by history of fall from height (10%) and only 4 cases of assault. Middle third shaft fractures were more common (53%) followed by lower and upper third respectively. Transverse fractures were maximum in number (45%) followed by oblique (29%). There were 13 spiral and 13 comminuted fractures. There were 75 (75%) close fractures and 25 (25%) open fractures. There were 25 cases (25%) of preoperative radial nerve palsy. Out of 25 cases, 23 had recovered completely. There was no iatrogenic nerve palsy seen in our study. Out of 25 cases explored nerve was found to be intact in 23 cases and contused in 2 cases. Most of cases (16) of radial nerve palsy were associated with fracture of middle third shaft humerus. Conclusion: For patients requiring surgical treatment of humeral shaft fractures, both dynamic compression plating and interlock nailing provide predictable methods for achieving fracture stabilization and ultimate healing. Plating requires extensive dissection, more blood loss and duration of surgery as compared to nailing. Antegrade interlock nailing performed properly is safe, effective and quick method.

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