Comparative study of results of ORIF with plating vs. CRIF with nailing in fracture midshaft humerus

Abstract

Background: Fractures of the humeral mid shaft are common. The advantages of operative management are early mobilization and patient comfort but, operative management carries the risk of technical errors and post-operative complications like infections and nerve injuries. Aims and Objectives: To study the fracture pattern and surgical management of fracture midshaft humerus by intramedullary nailing and plating. Materials and Methods: Forty eight patients were studied in the Department of Orthopaedic, MLB Medical College Jhansi from August 2018 to August 2019, after randomizing them into plating or interlocking nailing. A thorough history and clinical examination was done. Once the patients were randomized, pre-operative planning and investigations were done and the patients were posted for open reduction and internal fixation with plating or interlocking nailing. The patients were followed up every second week till radiological union was seen. The functional outcome was measured by the “Disabilities of Arm, Shoulder and Hand” (DASH) Questionnaire at nine months or at full recovery which ever was earlier. Result: Out of 60 fractures shaft of humerus, 48 were operated and the rest 12 treated conservatively. Mean time taken for radiological healing in the interlocking group was 14.05 and in plating was 16.06. The mean DASH score in the plating group was 24.1 and in the interlocking group it was 43.1 (0.024). Postoperatively in the plating group there were 13 complications and in the interlocking group there were 6 cases with complications (p=0.009). Conclusion: Cases where both plating and interlocking nailing can be done, plating should be preferred as plating offers better result with respect to pain and function of the shoulder joint.