Dynamic compression plating versus intramedullary interlocking nail technique: a prospective study in a tertiary care centre

Abstract

Background:A prospective study was performed to compare the efficacy and the outcome of the dynamic compression plating method and the interlocking nailing method for humeral shaft fractures.

Methods: 86 patients undergoing surgery for humeral shaft fractures were categorized into 2 groups of 43 each, undergoing Dynamic Compression Plating (DCP) and Intramedullary Interlocking (IMIL) technique after detailed clinical, physical and radiological history were taken. They were followed up for a total of 36 weeks or till the complete union of the bones, which ever was first.

Results:More than 60% of the patients were between 21-50 years of age. Out of the indications for surgery, 49 were fractures with unacceptable reduction and 23 of the fractures were with multiple injuries. Among the DCP group, only 14% of the patients took more than 20 weeks for the union of the fracture while in IMIL group this was further reduced to 9.3%. Union took place in <10 weeks in 48.8% of the patients in the IMIL group and 41.8% in the DCP group. The major complication that was observed in the DCP group was shoulder stiffness which was observed in 16.3% of the cases while in IMIL group, it was only 4.7%. An infection contributed to 11.6% of the complications on the IMIL group but was only 4.7% in the DCP group.

Conclusions:Though technically more demanding, our study showed that intramedullary interlocking system to be better than compression plating as it was minimally invasive with lesser blood loss.