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Fixation of fractures of the shaft of the humerus by dynamic compression plate or intramedullary nail

2000; British Editorial Society of Bone & Joint Surgery; Volume: 82; Issue: 3 Linguagem: Inglês

10.1302/0301-620x.82b3.9675

2044-5377

Robert G. McCormack, Donald C. Brien, Richard Buckley, Michael D. McKee, J. Powell, Emil H. Schemitsch,

Nerve Injury and Rehabilitation

The Journal of Bone and Joint Surgery. British volumeVol. 82-B, No. 3 TraumaFree AccessFixation of fractures of the shaft of the humerus by dynamic compression plate or intramedullary nailA PROSPECTIVE, RANDOMISED TRIALR. G. McCormack, D. Brien, R. E. Buckley, M. D. McKee, J. Powell, E. H. SchemitschR. G. McCormackClinical Associate ProfessorDepartment of Orthopaedics, Royal Columbian Hospital, 102-65 Richmond Street, New Westminster, British Columbia, Canada V3L 5P3., D. BrienResident, Orthopaedic SurgeryDepartment of Orthopaedics, Foothills Medical Centre AC 144E, 1403 29th Street, North West Calgary, Alberta, Canada T2N 2T9., R. E. BuckleyAssociate ProfessorDepartment of Orthopaedics, Foothills Medical Centre AC 144E, 1403 29th Street, North West Calgary, Alberta, Canada T2N 2T9., M. D. McKeeAssociate ProfessorDivision of Orthopaedics, St Michael's Hospital, 800 55 Queen Street East, Toronto, Ontario, Canada M5C 1R6., J. PowellClinical Associate ProfessorDepartment of Orthopaedics, Foothills Medical Centre AC 144E, 1403 29th Street, North West Calgary, Alberta, Canada T2N 2T9., E. H. SchemitschAssociate ProfessorDivision of Orthopaedics, St Michael's Hospital, 800 55 Queen Street East, Toronto, Ontario, Canada M5C 1R6.Published Online:1 Apr 2000https://doi.org/10.1302/0301-620X.82B3.0820336AboutSectionsPDF/EPUB ToolsAdd to FavouritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InRedditEmail AbstractWe randomised prospectively 44 patients with fractures of the shaft of the humerus to open reduction and internal fixation by either an intramedullary nail (IMN) or a dynamic compression plate (DCP). Patients were followed up for a minimum of six months. There were no significant differences in the function of the shoulder and elbow, as determined by the American Shoulder and Elbow Surgeons' score, the visual analogue pain score, range of movement, or the time taken to return to normal activity. There was a single case of shoulder impingement in the DCP group and six in the IMN group. Of these six, five occurred after antegrade insertion of an IMN. In the DCP group three patients developed complications, compared with 13 in the IMN group. We had to perform secondary surgery on seven patients in the IMN group, but on only one in the DCP group (p = 0.016).Our findings suggest that open reduction and internal fixation with a DCP remains the best treatment for unstable fractures of the shaft of the humerus. Fixation by IMN may be indicated for specific situations, but is technically more demanding and has a higher rate of complications.FiguresReferencesRelatedDetailsCited byHumeral shaft fracture: Outcomes of percutaneous antegrade intramedullary nailing using the long Telegraph® nail with dynamic distal lockingOrthopaedics & Traumatology: Surgery & Research, Vol. 108, No. 5Fractures de la diaphyse humérale : résultats de l'enclouage antérograde percutané par clou Telegraph® long avec verrouillage distal dynamiqueRevue de Chirurgie Orthopédique et Traumatologique, Vol. 108, No. 5Humeral shaft fractures: a cost-effectiveness analysis of operative versus nonoperative managementJournal of Shoulder and Elbow Surgery, Vol. 31, No. 9Antegrade intramedullary locking nail in the management of proximal and middle thirds of humeral diaphyseal fractures9 June 2022 | International Orthopaedics, Vol. 46, No. 8Open plate fixation versus nailing for humeral shaft fractures: a meta-analysis and systematic review of randomised clinical trials and observational studies5 July 2021 | European Journal of Trauma and Emergency Surgery, Vol. 48, No. 4Efficacy and Safety Evaluation of Intramedullary Nail and Locking Compression Plate in the Treatment of Humeral Shaft Fractures: A Systematic Review and Meta-analysisComputational and Mathematical Methods in Medicine, Vol. 2022INTRA-MEDULLARY NAILING FOR HUMERAL SHAFT FRACTURES:A CASE SERIES1 June 2022 | INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCHSimilar Complication Rates for Humeral Shaft Fractures Treated With Humeral Nails Versus Open Reduction and Internal Fixation With Plating3 February 2022 | Orthopedics, Vol. 80Trauma1 October 2021Bone marrow aspirate concentrate/platelet-rich fibrin augmentation accelerates healing of aseptic upper limb nonunions5 June 2021 | Journal of Orthopaedics and Traumatology, Vol. 22, No. 1Newer generation straight humeral nails allow faster bone healing and better functional outcome at mid-term20 October 2021 | Journal of Orthopaedic Surgery and Research, Vol. 16, No. 1Surgical management of humeral shaft nonunions. 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