Study on Percutaneous Intramedullary Nailing In Adult Diaphyseal Humeral Fractures

Ajmal Khan Silro,Mohsin Aijaz Soomro,Muhammad Faraz Jokhio,Najeeb Ur Rehman,Niaz Hussain Keerio,Raheel Akbar Baloch,Syed Shahid Noor

doi:10.9734/jpri/2021/v33i39a32161

Abstract

Objective: The objective of this research was to evaluate close fixation techniques for fractures of humerus via percutaneous intramedullary nailing. Methodology: This was a prospective study, carried out in Suleman Roshan Medical College Tando Adam Pakistan from January 2019 to January 2020. About 60 patients with humeral shaft fractures were made part of this study with a follow-up period of about 1 to 2 years. The inclusion criteria were humeral fractures that were of less than 7 days prior to surgery, the displacement of fracture >20° in sagittal as well as coronal plane, and the distance measuring >2cm between the two fragments. All patients were treated via the closed fixation technique. Multiple nails that were slender as well as flexible (3-5) were used in the close fixation technique including rush nails (45 patients) and ender nails (15 patients). All the patients within their follow-up periods were evaluated for ROM, pain, or any kind of deformity, and all the patients were assessed radiographically to check the process of bone union. Results: The outcome was analyzed before implant i.e at six months and after the implant was removed. About 86% patients (n= 52) revealed satisfactory outcomes at six months. About 5 patients revealed non-union or delayed union that was healed after 2nd surgery of bone grafting in 3 patients and injections associated with bone marrow in 2 patients. Stiffening of the shoulder was found to be a frequent complication that decreased significantly when the position of nail insertion was changed during the research. Conclusion: The technique of intramedullary nailing displayed many benefits including minimum tissue stress, a quick surgery time, decreased period of hospital stay, and rapid bone union.

Highlights

The humerus is a long bone of the upper extremity that is attached from the distal end to the forearm bones taking part in the elbow joint and from the proximal end to the shoulder joint
Closed injury is the cause of several independent humeral diaphyseal fractures, which account for 1 to 3 percent of all fractures
Conservative intervention, open reduction as well as internal fixation (ORIF), plating, or closed reduction as well as IM nailing are all possibilities for Humeral diaphyseal fracture treatment

Summary

Introduction

The humerus is a long bone of the upper extremity that is attached from the distal end to the forearm bones taking part in the elbow joint and from the proximal end to the shoulder joint. If there is any discontinuity in the middle of the bone, it is referred to as a fracture of the humeral shaft or diaphyseal. Injuries from collision accidents or maybe football tackle or due to any pathological condition like metastatic bone cancer can lead to humeral fractures [1]. The humeral fractures account for 1 to 7 percent of all fractures in the elder population and it was found to be 3rd most prevalent fracture followed by the fractures associated with the hip as well as wrist [2]. Closed injury is the cause of several independent humeral diaphyseal fractures, which account for 1 to 3 percent of all fractures. Conservative intervention, open reduction as well as internal fixation (ORIF), plating, or closed reduction as well as IM nailing are all possibilities for Humeral diaphyseal fracture treatment. Any external fixator is a possibility, but it is seldom implemented [4]

Methods

Results

Conclusion