In Closed Humeral Shaft Fractures, Internal Fixation Surgery Did Not Improve Functional Outcomes at 12 Months Compared with Nonoperative Functional Bracing

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
William Obremskey
Keyword(s):  
Internal Fixation ◽  
Functional Outcomes ◽  
Humeral Shaft ◽  
Humeral Shaft Fractures ◽  
Shaft Fractures

scholarly journals Locked Intramedullary Nailing versus Dynamic Compression Plating for Humeral Shaft Fractures

2009 ◽  
Vol 17 (2) ◽  
pp. 139-141 ◽  
Author(s):  
Amit B Putti ◽  
Rajendra B Uppin ◽  
Babu B Putti
Keyword(s):  
Intramedullary Nailing ◽  
Functional Outcomes ◽  
Dynamic Compression ◽  
Adhesive Capsulitis ◽  
Humeral Shaft ◽  
Complication Rates ◽  
Humeral Shaft Fractures ◽  
Shaft Fractures ◽  
Compression Plating ◽  
Dynamic Compression Plating

Purpose. To compare functional outcomes, union and complication rates in patients treated with locked intramedullary nailing or dynamic compression plating for humeral shaft fractures. Methods. 32 men and 2 women with humeral shaft fractures were randomised to undergo locked antegrade intramedullary nailing (IMN, n=16) or dynamic compression plating (DCP, n=18). Patients with pathological fractures, grade-III open fractures, neurovascular injury, or fractures for more than 2 weeks were excluded. Fractures were classified according to the AO classification system (one in A1, 6 in A2, 12 in A3, 6 in B1, and 9 in B2). 28 were injured in road traffic accidents. The functional outcome (according to the American Shoulder and Elbow Surgeons [ASES] score) and rates of union and complication of the 2 groups were compared. Results. All patients were followed up for a minimum of 24 months. In the respective IMN and DCP groups, the mean ASES scores were 45.2 and 45.1 (p=0.69), the complication rates were 50% and 17% (p=0.038), and the non-union rates were 0% and 6% (p=0.15). In the IMN group, 2 sustained iatrogenic fractures during nail insertion; 2 had transient radial nerve palsies; one underwent nail removal for shoulder impingement; and 3 had adhesive capsulitis. In the DCP group, one underwent re-operation for implant failure; one had a superficial infection; and one developed adhesive capsulitis. Conclusion. The complication rate was higher in the IMN group, whereas functional outcomes were good with both modalities.

scholarly journals Assessment of Shoulder Function after Internal Fixation of Humeral Diaphyseal Fractures in Young Adults: A Prospective Comparative Study

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Hossam Fathi Mahmoud ◽  
Ahmed Hatem Farhan ◽  
Fahmy Samir Fahmy
Keyword(s):  
Young Adults ◽  
Blood Loss ◽  
Internal Fixation ◽  
Operative Time ◽  
Shoulder Function ◽  
Humeral Shaft ◽  
Humeral Shaft Fractures ◽  
Shaft Fractures ◽  
Group A ◽  
Group B

Background. Humeral shaft fractures are commonly encountered in casualties. There are different methods of operative internal fixation with no consensus on the best technique. The objective of this study was to assess shoulder function and rate of complications among two different options of fixation, intramedullary nailing, and minimal invasive plate osteosynthesis (MIPO) in young adults. Methods. Forty-two patients with humeral shaft fractures were included in the study and divided into two equal groups: group A treated with antegrade intramedullary locked nails (IMN) and group B with MIPO. Fracture union was evaluated with serial X-rays, and shoulder function was assessed in both groups using the scale of the American Shoulder and Elbow Surgeons (ASES), University of California at Los Angeles Shoulder Scale (UCLA), and visual analog score (VAS). The mean differences between groups were recorded and considered significant if the P value was ˂0.05. Results. The results were reported prospectively with no significant differences in mean age, sex, side of injury, type of fracture, mechanism of injury, and the follow-up period between the groups studied. Group A had shorter operative time and minimal blood loss than group B. Regarding shoulder function scores (ASES, UCLA, and VAS), the results in the MIPO group were better than the IMN group with shorter time of union and fewer complications. Conclusion. Despite a shorter operative time and lower blood loss during locked intramedullary nail fixation in the management of humeral shaft fractures, MIPO enables more superior shoulder function with better fracture healing and lower morbidities.

scholarly journals Functional outcomes in humeral shaft fractures-Conservative management versus operative procedure

2018 ◽  
Vol 4 (1d) ◽  
pp. 243-246
Author(s):  
Kanwarjit S Sandhu ◽  
Amandeep S Bakshi ◽  
Ravinder K Banga ◽  
Karamdeep S Kahal ◽  
Saurabh Langeh
Keyword(s):  
Conservative Management ◽  
Functional Outcomes ◽  
Operative Procedure ◽  
Humeral Shaft ◽  
Humeral Shaft Fractures ◽  
Shaft Fractures

Lateral Approach for Internal Fixation of the Distal Humeral Shaft Fractures

2004 ◽  
Vol 17 (2) ◽  
pp. 83 ◽  
Author(s):  
Seung Koo Rhee ◽  
Joo Yup Lee ◽  
Yoo Joon Suh ◽  
Joon Ho Lee ◽  
Nong Kyoum Ahn
Keyword(s):  
Internal Fixation ◽  
Lateral Approach ◽  
Humeral Shaft ◽  
Humeral Shaft Fractures ◽  
Shaft Fractures

scholarly journals A Comparative Study on Internal Fixation Using Long Proximal Intramedullary Nail for the Treatment of Humeral Shaft Fracture according to Fracture Types

2019 ◽  
Vol 22 (2) ◽  
pp. 87-92
Author(s):  
Chang-Hyuk Choi ◽  
Chung-Mu Jun ◽  
Jun-Young Kim
Keyword(s):  
Internal Fixation ◽  
Shaft Fracture ◽  
Humeral Shaft Fracture ◽  
Optimal Choice ◽  
Humeral Shaft ◽  
Humeral Shaft Fractures ◽  
Shaft Fractures ◽  
Group I ◽  
The Mean ◽  
Group Ii

Background: This study was conducted to compare the radiological and clinical outcomes of internal fixation using a Polarus humeral nail for treatment of a humeral shaft fracture according to fracture types.Methods: From 43 patients, 13 were excluded and 30 patients were included. The 30 patients were divided into 2 groups: 15 in group I (Orthopaedic Trauma Association/Arbeitsgemeinschaft f?r Osteosynthesefragen classification type A and B) and 15 in group II (type C). The mean age was 63.1 years (range, 20?87 years), and mean follow-up period was 2.3 years (range, 1.0?6.1 years). The causes of injuries were as follows: 12, traffic accidents; 14, simple slips; 2, simple falls; 2, contusions after lower energy trauma. Radiological and clinical evaluations were performed.Results: Radiological union was confirmed by plain anteroposterior and lateral radiographs on average of 5.0 months in group I, and 8.4 months in group II, respectively. Differences between the two groups were statistically significant (<i>p</i><0.01). The clinical union value was 1.6 in group I, and 2.0 months in group II, but these values did not differ significantly (<i>p</i>=0.441). The mean Korean shoulder scoring system scores were 89.7 and 90.6, which did not differ significantly (<i>p</i>=0.352).Conclusions: Intramedullary nailing using the Polarus humeral nail is considered to be a good treatment modality for all types of humeral shaft fractures. Additionally, the Polarus humeral nail can be an optimal choice for the treatment of complex type fractures such as segmental or comminuted humeral shaft fractures.

scholarly journals Comparative study of surgical management of humeral shaft fractures with dynamic compression plate in Henry’s and Thompson’s approach in adults

2017 ◽  
Vol 3 (2) ◽  
pp. 231
Author(s):  
C. D. Deepak ◽  
Mahesh D. V. ◽  
Abdul Ravoof ◽  
Sankosh Krishna Sai
Keyword(s):  
Internal Fixation ◽  
Surgical Management ◽  
Fracture Fixation ◽  
Dynamic Compression ◽  
Humeral Shaft ◽  
Humerus Fracture ◽  
Dynamic Compression Plate ◽  
Humeral Shaft Fractures ◽  
Shaft Fractures ◽  
Compression Plate

<p class="abstract"><strong>Background:</strong> Fractures of the humeral shaft account for roughly 3% to 5% of all fractures. The predominant causes of humeral shaft fractures include simple falls or rotational injuries in the older population and higher energy mechanisms in the younger patients including motor vehicle accidents, assaults, fall from height and throwing injuries. Treatment options for humeral fractures vary according to the type of fracture, age group, bone density, soft tissue status and associated complications. Surgical management of shaft humerus fractures by plating can be done mainly through Thompson’s (posterior) approach and Henry’s (antero-lateral) approach.</p><p class="abstract"><strong>Methods:</strong> The study was conducted in patients treated for shaft humerus fracture at Adhichunchanagiri Institute of Medical Science, BG Nagara from the month of August 2014 to January 2016. Twenty patients diagnosed as shaft humerus fracture were taken into the study, all were undergone open reduction and internal fixation using dynamic compression plate in Thompson’s and Henry approach. Patients’ age more than 18 years were taken up for the study. Patients were followed up at 3 weeks, 6 weeks, 6 months.<strong></strong></p><p class="abstract"><strong>Results:</strong> The sample consisted of twenty shaft humerus fracture patients with 10 males and 10 females. The patients’ ages were more than 18 years where 13 cases (65%) between 26 to 55 years. Among these 20 patients, 10 involved the right side and 10 involved the left side. All patients achieved clinical and radiological union at 6 month follow up. According to Constant Murley Score, excellent result were found in 11 patients (55%), good in 2 patients (10%) and fair in 7 patients (35%). According to Mayo elbow performance index, 17 patients showed excellent outcome (85%) and 3 patients showed good outcome (15%).</p><strong>Conclusions:</strong>Dynamic compression plating is the best modality of management for the internal fixation of humeral shaft fractures. It is found that the fracture fixation of upper and middle one-third humerus in Henry’s approach is easier, lower one-third humeral fractures are not possible because the plate at the supracondylar ridge poses difficulty to fix. Fracture fixation of the lower one third and middle one third is easier in Thompson’s approach because of the flat surface of the bone and offers better plate contour.<p> </p>

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