COMPARISON OF INTRAMEDULLARY NAIL AND PLATE IN MANAGEMENT OF MID DIAPHYSEAL FRACTURES OF HUMERUS

Dr.m.d. Faisal, Dr.A.B. Ingale

Abstract


Introduction

Comparison of Intramedullary nailing with nailing in management of  Mid diaphyseal fractures of humerus is still matter of debate due to lack of definitive evidence. The aim of our study was to compare the results of nailing and plating with regards to functional outcome, radiological union, surgical time ,hospital stay and  complication.

Material and methods

4o patients were included in our study.20 patients were managed with intramedullary nail and 20 with open reduction and internal fixation with plate. Mean age in plating group A was 44.95 years and 38.1 years   in nailing group B. 15 were male and 5 were female in plating group A and 11 were male and 9 were female in nailing group B. Road traffic accident was most common mode of injury. In plating group A 13 belong to AO type 12 A, 5 to AO type 12 B and 2 to AO type 12C .In nailing group B 6 belong to AO type 12 A, 9 to AO type 12 B and 5 to AO type 12C. Functional outcome was assessed using American shoulder and elbow score in both the groups.

Results

The average operating time  was 74.65 minutes  in plating group A and  58.5 minutes in nailing group B. Mean blood loss was 294.6 ml  in plating group A and 159.2 ml in nailing group B Average Hospital stay was 7.3 days  in plating group A and 4.7 days in nailing group B. Mean time to union was 14.35 weeks  in plating group A and 13.05 weeks in nailing group B. Mean ASES at the end of follow up was  44.85 in plating group A and 45.65 in nailing group B.

Conclusion

In our study no difference was observed in plating and nailing group with respect to union time and and functional outcome. Nailing group had added advantages of less surgical time, shorter hospital stay , less blood loss and shorter union time. We conclude that nail is an effective option compared to plate in the management of mid diaphyseal fractures of humerus.


Keywords


NAIL,PLATE,HUMERUS

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References


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