Effects of Locking Compression Plate and Intramedullary Nailing on the Healing, Stress Factors and Inflammatory Factors of Patients with Open Humerus Fractures in Emergency

Abstract

To investigate the efficacy of internal fixation with locking compression plate and intramedullary nailing in the treatment of open humerus fractures in emergency and their influences on the stress factors and inflammatory factors of patients. Sixty patients with open humerus fractures admitted in emergency department from December 2017 to December 2019 were enrolled in this study, and they were randomly divided into group A (n = 30) and group B (n = 30) based on treatment methods. Patients in group A received the internal fixation with locking compression plate, while patients in group B were treated with intramedullary nailing. The study compared various factors between the two groups, including operation time, surgical incision size, intraoperative blood loss, postoperative weight-bearing time, healing time, treatment effectiveness, inflammatory factors, stress factors, and the incidence of postoperative complications. In group B, patients had significantly shorter operation times and less intraoperative blood loss compared to group A (P < 0.05). Additionally, patients in group B started postoperative shoulder training earlier. The surgical incision size and fracture healing time did not show significant differences between the two groups (P > 0.05). The excellent and good rate of treatment in group A was 93.33% while 96.67% for group B (P > 0.05). On the 7th day after operation, patients in both groups exhibited increased serum levels of ESR, WBC, and IL-6. However, group B demonstrated significantly lower levels of these factors compared to group A (P < 0.05). Moreover, the norepinephrine (NE), epinephrine (E) and cortisol (Cor) all increased, and group B demonstrated lower levels than group A (P < 0.05). The incidence of postoperative complications in groups A and B were 36.67% and 13.33%, respectively (P < 0.05). Both internal fixation with a locking compression plate and intramedullary nailing are effective in treating open humerus fractures in emergency cases. However, intramedullary nailing offers advantages such as shorter operation time, reduced intraoperative blood loss, lower postoperative stress and inflammatory responses, and a lower incidence of postoperative complications. Therefore, intramedullary nailing should be promoted as a treatment option for these fractures.