Comparison of expandable intramedullary nail versus locked compression plate for treatment of humeral shaft fractures

Abstract

Objective To compare the effectiveness of expandable intramedullary nail(EIMN) versus locked compression plate (LCP) in the treatment of humeral shaft fractures of AO types A and B. Methods The clinical data were retrospectively analyzed and compared of the 44 humeral shaft fractures which had been treated between May 2012 and February 2016. There were 26 men and 18 women, from 23 to 66 years of age (average, 41.5 years). By AO classification, 22 cases were type 12-A and 22 type 12-B. EINM was used in 22 patients with an average age of 41.3±11.7 years and LCP in 22 ones with an average age of 41.6±10.3 years. The 2 groups were compared in terms of intraoperative blood loss, operative time, hospital stay, union time, union rate, Constant and Mayo scores at the final follow-ups, and complications as well. Results The 2 groups were compatible without significant differences in the preoperative demo-graphic data (P >0.05). All the 44 patients were followed up for 10 to 18 months (average, 12 months). The intraoperative blood loss (76.4±18.66 mL), operative time (69.1±13.2 min), incision length (5.8±1.5 cm) and union time (13.2±8.4 w) in the EIMN group were significantly better than those in the LCP group (138.6±39.4 mL, 96.4±14.2 min, 8.5±1.4 cm and 18.4±6.6 w, respectively) (P< 0.05). There was also a significant difference between the 2 groups in the total complication rate[18.2%(4/22) versus 50.0% (11/22)] (P< 0.05). No deep infection or should pain was observed in either group. Conclusions In the treatment of humeral shaft fractures of AO types 42-A and 42-B, compared with LCP, EIMN may have ad-vantages of less intraoperative blood loss, operative time, union time and complications. The 2 methods are similar in hospital stay and final functional recovery of the should joint. Key words: Humeral fractures; Fracture fixation, internal; Bone nails; Bone plates