Study of effectiveness of interlocking nail in management of fracture shaft humerus

Abstract

Background & Objectives: Operative management of humeral shaftfractures can be with plate osteosynthesis or with intramedullary nailing. As the intramedullary nails can be introduced in a closed manner, they preserve the fracture hematoma, providing early fracture consolidation with higher union rates and low infection rates. Interlocking achieves rotational stability providing early mobilization of the neighbouring joints. But, with antegrade nailing they do have a disadvantage of causing shoulder stiffness. In this study we have tried to analyze the outcome in terms of time for consolidation, union rates, functional results and complications of humeral shaft fractures managed with intramedullary nailing. Methods: 20 adult patients with acute humeral shaft fractures were treated withclosed intramedullary nailing in antegrade manner. There were 15 males and 5 females with an average age of 35.75 years (21-60 years). All the patients were followed over a period of 2 years and results were analyzed. Results: 17 (85%) fractures united with a average consolidation time of 13.5 weeks (10-16 weeks), 2(10%) fracture ended in delayed union which needed bone grafting.1(5%) case needed redoing with plate osteosynthesis due to severe nail prominence. There was no case of iatrogenic radial nerve palsy. Nail impingement was seen in 4(20%), shoulder stiffness in 1(5%) and none of the patients got infected. Functional results were excellent in 15(75%), moderate in 4(20%) and poor in 1(5%). Conclusion: Closed intramedullary nailing offers a safe and reliable method offixing humeral shaft fractures, with early fracture consolidation and higher union rates. It provides early rehabilitation and reduces the hospital stay.