Outcome of Dynamic Compression Plating of Humerus Shaft Fracture In Adults

Syed Jahanzeb, Saeed Ahmed Shaikh, Yasir Hussain

Abstract

Objective

To determine the outcome of dynamic compression plating in humerus shaft fracture in adults.

Study design

Cross sectional study.

Place & Duration of study

Department of Orthopedic Surgery, Jinnah Postgraduate Medical Centre (JPMC) Karachi, from November 2017 to May 2018.

Methodology

Patients with isolated, close humeral shaft fractures between 21 to 60 years, of either gender presented within four weeks of injury. Patients with radial nerve injury due to trauma (pre-surgery), open fractures, multiple or pathological fractures were ruled out from the study. Brief history regarding fracture duration and comobids such as diabetes, hypertension were obtained.  Open reduction and internal fixation was done and dynamic compression plate was applied on lateral surface of humerus through anterolateral approach. Postoperatively radial nerve assessment was done and patients were followed up at monthly intervals with clinical and radiological evaluation. Final outcome was determined at the end of six months using Rommens grading.

Results

A total of 65 patients with humeral shaft fracture were managed. There were 36 (55.4%) males and 29 (44.6%) females. Mean age of patients was 36.29±11.17 years. Average duration of fracture was 6.27±4.70 days. The mean BMI was 26.08±4.12 kg/m2. Most of the patients were noted in the age group between 31-45 year (n=30 - 46.2%). Fracture location  was  on  left  side  in 45 (69.2%) and right in 20 (30.8%) patients. The most frequent mechanism of injury was motor vehicle accidents (n=47 - 72.3%) followed by assault (n=12 - 18.5%).

According to Rommens criteria, excellent results were seen in 30 (46.2%) cases, good in 26 (40%) and poor results in 9 (13.8%) patients. Excellent and good results considered satisfactory were found in 56(86.2%) patients. Poor results were related to aseptic non union in seven patients (10.7%) and septic non union in two (3.1%) patients. Radial nerve palsy was found in five (7.6%) patients out of which three recovered well in three months period whereas remaining two (3.0%) required further procedures of tendon transfer.

Conclusion

Plating of humeral shaft fracture was found to be satisfactory method of treatment with high fracture union rates, good movements at shoulder and elbow joints and low complication rate.

Key words •

Dynamic compression plating, Fracture shaft Humerus, Intramedullary nailing.