Functional outcome of diaphyseal fractures of humerus in adults treated with closed interlocking nails: A prospective study

Somnath Ghosh, B. Nayak, Dhananjoy Bera, S. Samanta
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Abstract

Background: Diaphyseal fractures of humerus are common, representing 3% of all fractures and 20% of all humerus fractures. Though compression plate osteosynthesis is the gold standard, interlocking intramedullary nailing is also a reliable option. In this present study we evaluated the functional outcome of diaphyseal fractures of humerus treated with interlocking nails. A total of 36 patients with diaphyseal fractures of humerus, selected Materials and Methods: between OCTOBER 2020 to MAY 2021 were managed by closed interlocking nail of humerus. This was a prospective study and all patients were followed up to a minimum of 6 months. The primary outcome measures were functional outcome assessed using DASH Score (The Disabilities of the Arm, Shoulder & Hand Score) & Constant-Murley scoring system respectively. Secondary outcomes were intra-operative conditions such as operative time and blood loss and post-operative complications. The mean time of radiological union was 15.7 weeks ranging from14-26 Results: weeks. All 36 fractures were united including one delayed union which united at 26 weeks. In our series, 4 patients had post operative shoulder stiffness including one prominent nail, 1 patient developed radial nerve neuropraxia which recovered in 8 weeks. All patients were evaluated on the basis of Constant Murley score for shoulder function and DASH score. In our study of 36 patients 69.4% got excellent results, 19.4% got good results, 8.3% got moderate/fair results and 2.8% got poor results. Interlocking nailing is a relatively quick, minimally invasive, biomechanica Conclusion: lly sound, cosmetically better method of internal stabilization of shaft humerus fractures with less union time, less infection and lesser threat to radial nerve and other complications. Besides it allows early mobilization. With correct anatomical knowledge, preoperative planning, good surgical techniques and postoperative rehabilitation interlocking humeral nailing is a viable option in the management of fracture shaft humerus promising excellent outcome.
闭式交锁钉治疗成人肱骨骨干骨折的功能结局:一项前瞻性研究
背景:肱骨骨干骨折很常见,占所有骨折的3%,占所有肱骨骨折的20%。虽然加压钢板固定是金标准,但交锁髓内钉也是一种可靠的选择。在本研究中,我们评估了联锁钉治疗肱骨骨干骨折的功能结果。选择材料和方法于2020年10月至2021年5月对36例肱骨骨干骨折患者进行肱骨闭式交锁钉治疗。这是一项前瞻性研究,所有患者随访至少6个月。主要结局指标分别采用DASH评分(手臂、肩膀和手的残疾评分)和Constant-Murley评分系统评估功能结局。次要结果是术中情况,如手术时间、出血量和术后并发症。平均放射愈合时间15.7周,范围14 ~ 26周。所有36例骨折均愈合,其中一例延迟愈合,于26周愈合。在我们的研究中,4例患者术后出现肩关节僵硬,包括1例突出的指甲,1例患者出现桡神经失用症,8周后恢复。所有患者均以Constant Murley肩关节功能评分和DASH评分为基础进行评估。在我们研究的36例患者中,69.4%的患者获得了优异的结果,19.4%的患者获得了良好的结果,8.3%的患者获得了中等/一般的结果,2.8%的患者获得了较差的结果。结论:联锁内钉是一种较快速、微创、美观的肱骨骨干骨折内固定方法,愈合时间短,感染少,对桡神经及其他并发症的威胁小。此外,它允许早期动员。正确的解剖学知识、术前计划、良好的手术技术和术后康复,联锁肱骨内钉是治疗肱骨骨干骨折的可行选择,具有良好的疗效。
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