Humeral Diaphyseal Fracture Nonunion: An Audit of the Outcome from Intramedullary Nailing and DCP Plating.

Abstract:

Purpose:This study aims to compare the functional outcomes of nonunion humeral diaphyseal fractures following conservative treatment when managed surgically with either a plate or intramedullary (IM) nail fixation. Methods:This was a retrospective study of 56 patients with nonunion humeral fractures following conservative treatment who underwent plate or IM nail fixation between 2007 and 2014. Comparison was made for short term profile (intraoperative blood loss, duration of surgery, and length of hospitalization) and long term clinical outcome with functional score (Constant-Murley score (CMS)) and Disabilities of the Arm, Shoulder and Hand (DASH) score). The union and complication rate were also compared. Results:There were 36 and 20 patients included in plate and IM nail fixation group with the average of 36.14 ± 7.54-month follow-up time. The intraoperative blood loss, duration of surgery, and length of hospitalization were superior in IM nail group compared to plate group (p < 0.001, p < 0.001, and p < 0.001, respectively). The mean CMS and DASH score were superior in the plate group compared to the IM nail group (82.40 ± 16.84 versus 77.58 ± 12.96; 17.46 ± 11.05 versus 20.86 ± 11.63, respectively; with p = 0.246, p = 0.299, respectively). Plate fixation group showed higher union rate and complication rate compared to IM nail group (100% versus 90%, 13.8% versus 10%, respectively). Conclusions:IM nail and plate fixation demonstrated comparable clinical outcome. IM nail fixation showed superior short term result with lower complication rate which benefits the elderly group patients with significant comorbidities.

journal_name

Biomed Res Int

authors

Micic I,Kholinne E,Kwak JM,Sun Y,Nanda A,Kim H,Koh KH,Jeon IH

doi

10.1155/2019/9107898

subject

Has Abstract

pub_date

2019-07-22 00:00:00

pages

9107898

eissn

2314-6133

issn

2314-6141

journal_volume

2019

pub_type

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