Comparison of Outcome of Intramedullary Interlocking Nail Versus Dynamic Compression Plate for Treatment of Humeral Shaft Fractures
DOI:
https://doi.org/10.70749/ijbr.v3i7.3158Keywords:
Bone plates, Fracture fixation, Humeral fractures, Orthopedic procedures, Treatment outcomeAbstract
Background: Humeral shaft fractures are common orthopedic injuries and can lead to significant functional disability if not treated properly. Dynamic compression plate and intramedullary interlocking nail are commonly used surgical techniques for fixation of these fractures, but there is still controversy regarding the better method in terms of functional recovery and outcome. Objective: To compare the frequency of excellent functional outcome with dynamic compression plate and intramedullary interlocking nail for treatment of humeral shaft fractures. Study Design: Randomized controlled trial. Duration and Place of Study: The study was conducted from 16th February 2025 to 16th June 2025 at the Orthopedic A Unit, Khyber Teaching Hospital, Peshawar. Methodology: A total of sixty patients aged between eighteen and sixty years with closed humeral shaft fractures classified under type A1 to A3 of the AO/OTA system were enrolled and randomly divided into two equal groups. Group A underwent open reduction and internal fixation with dynamic compression plate, and Group B received fixation by intramedullary interlocking nail through antegrade or retrograde approach. Patients were followed to evaluate bone healing and functional recovery using the Disabilities of the Arm, Shoulder and Hand scoring system. An excellent outcome was defined as a score below twenty-four. Results: The mean age of participants was 42.48 ± 9.42 years. Excellent functional outcome was achieved in twenty-six patients (86.7%) treated with dynamic compression plate and twelve patients (40.0%) treated with intramedullary interlocking nail, showing a statistically significant difference (p<0.001). Conclusion: Dynamic compression plate fixation provides superior functional outcomes compared with intramedullary interlocking nail for the treatment of humeral shaft fractures.
Downloads
References
1. Gallusser N, Barimani B, Vauclair F. Humeral shaft fractures. EFORT Open Rev. 2021;6(1):24-34.
https://doi.org/10.1302/2058-5241.6.200033.
2. Łukasz W, Ryszard T, Maria D. Radial nerve palsy associated with humeral shaft fractures in children. Biomed Res Int. 2023;2023:3974604. https://doi.org/10.1155/2023/3974604.
3. Nshimiyimana A, Ingabire JCA, Byiringiro JC, Habumugisha B, Mwizerwa JL. The outcome of nonoperative treatment for adult humeral shaft fractures using a U-shaped slab in resource-limited settings: a prospective cohort study. J Orthop Surg Res. 2024;19(1):316.
https://doi.org/10.1186/s13018-024-04794-w.
4. Martinez-Catalan N. Conservative treatment of proximal humerus fractures: when, how, and what to expect. Curr Rev Musculoskelet Med. 2023;16(2):75-84.
https://doi.org/10.1007/s12178-022-09817-9.
5. Yang J, Liu D, Zhang L, Lu Z, Liu T, Tao C. Treatment of humeral shaft fractures: a new minimally-invasive plate osteosynthesis versus open reduction and internal fixation: a case control study. BMC Surg. 2021;21(1):349.
https://doi.org/10.1186/s12893-021-01347-4.
6. Naveen Kumar Reddy CV, Naik S, Biradar RK. Functional outcomes of intramedullary interlocking nailing for humeral shaft fractures: a prospective study. Cureus. 2025; 17(4):e82550.
https://doi.org/10.7759/cureus.82550.
7. Mahmoud HF, Farhan AH, Fahmy FS. Assessment of shoulder function after internal fixation of humeral diaphyseal fractures in young adults: a prospective comparative study. Adv Orthop. 2021;2021:9471009.
https://doi.org/10.1155/2021/9471009.
8. Karagoz B, Erdem M, Cukurlu M, Agir I. Comparison of three different surgical treatment methods in humeral shaft fractures. Pan Afr Med J. 2022;42:88.
https://doi.org/10.11604/pamj.2022.42.88.34692.
9. Huxman C, Lewis G, Armstrong A, Updegrove G, Koroneos Z, Butler J. Mechanically compliant locking plates for diaphyseal fracture fixation: a biomechanical study. J Orthop Res. 2025;43(1):217-227.
https://doi.org/10.1002/jor.25968.
10. Zhang Z, Lin Z, Qiu Q, Xiao X, Su S, Wen X, He B. Systematic review of humeral shaft fracture (OTA/AO 12) complicated with iatrogenic radial nerve injury. Eur J Med Res. 2024;29(1):385.
https://doi.org/10.1186/s40001-024-01981-7.
11. Van Bergen SH, Mahabier KC, Van Lieshout EMM, et al. Humeral shaft fracture: systematic review of non-operative and operative treatment. Arch Orthop Trauma Surg. 2023; 143:5035-5054.
https://doi.org/10.1007/s00402-023-04836-8.
12. Hussain B, Ullah Z, Hussain G, et al. Compare the functional outcome of dynamic compression plating versus interlocking nail procedure for fracture shaft of humerus. Pak J Med Health Sci. 2020;14(4):1314-1317.
13. Ansari HR, et al. Comparison of functional outcome between DCP and intramedullary nail in the management of simple transverse humerus fracture. Pak Postgrad Med J. 2022;33(1):10-14. https://doi.org/10.51642/ppmj.v33i01.418.
14. Reddy CV, Mohan KJ. A comparative analysis of interlocking nail and dynamic compression plating as treatment modality of humeral shaft fractures. Ann Int Med Dent Res. 2015;1(2):131-133.
15. Wang Y, Kayastha Y, Cao Y, et al. Outcome of humeral shaft fracture treated with intramedullary nail and plate fixation. J Coll Physicians Surg Pak. 2020;30(1):73-78.
https://doi.org/10.29271/jcpsp.2020.01.73
16. Kumar LLS. Dynamic compression plating versus intramedullary interlocking nail technique: a prospective study in a tertiary care centre. Int Surg J. 2016;3(2):653-657.
https://doi.org/10.18203/2349-2902.isj20161139.
17. Nadeem A, Abbasi H. Outcomes of intramedullary nailing versus plate fixation in the management of humeral shaft fractures: a systematic review and meta-analysis. Cureus. 2024;16(10):e72473. https://doi.org/10.7759/cureus.72473.
18. McCormack RG, Brien D, Buckley RE, et al. Fixation of fractures of the shaft of the humerus by dynamic compression plate or intramedullary nail: a prospective, randomised trial. J Bone Joint Surg Br. 2000;82-B:336-339.
https://doi.org/10.1302/0301-620x.82b3.0820336
19. Chandan RK, Sinha VP, Bhushan DP. Comparison of results between dynamic compression plate and interlocking nail for management of fracture shaft of humerus. Int J Orthop Sci. 2020;6(1):249-252.
https://doi.org/10.22271/ortho.2020.v6.i1e.1867.
20. Akalin Y, Şahin İG, Çevik N, et al. Locking compression plate fixation versus intramedullary nailing of humeral shaft fractures: which one is better? Int Orthop. 2020;44(12):2393-2404.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Indus Journal of Bioscience Research
This work is licensed under a Creative Commons Attribution 4.0 International License.
