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

Abstract

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 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 from 14-26 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, biomechanically 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.