Fixation with intramedullary nail and plate in the treatment of adult humeral shaft fracture: comparison of radial nerve injury and non-union rate

doi:10.3969/j.issn.2095-4344.2015.13.022

Abstract

Abstract:

BACKGROUND: Internal fixation is the main treatment of humeral shaft fractures, especially for cases accompanied several injuries. According to the fracture reduction method and fixation methods, the commonly used repair methods include intramedullary nail and minimally invasive plate. How to choose a safe and effective method of internal fixation is a hot issue in the repair of humeral shaft fractures.
OBJECTIVE: To explore the clinical effect of different fixations of intramedullary nail and plate in the treatment of adult humeral shaft fracture.
METHODS: A total of 252 patients with humeral shaft fracture recruited from Heze Municipal Hospital from May
2010 to May 2013 were randomly divided into two groups, with 126 cases in each group. Patients in the two groups were treated with intramedullary nail fixation and plate fixation, respectively. The average operation time, intraoperative blood loss, hospital stays, and healing time of fracture in the two groups were recorded. All patients were followed up for 1 year postoperatively, the incidence of radial nerve injury, infection and non-union was compared. The recovery of shoulder joint and elbow joint of patients was assessed with Neer method and Mayo method, respectively.
RESULTS AND CONCLUSION: After treatment, the rate of primary success of internal fixation showed no significant differences between the two groups (χ2=0.399 7, P > 0.05). The average operation time, intraoperative blood loss, the healing time of fracture and hospital stays in the intramedullary nail group were significantly shorter than that in the plate group B, the difference of the results were extremely significant in two groups (t=15.442 5, 21.713 4, 8.217 6, 1.214 8, P < 0.01). After 1-year follow-up, the incidence of radial nerve injury showed extremely significant differences between the two groups (χ2=8.262 3, P < 0.01); the incidence of nonunion in the intramedullary nail group was significantly lower than that in the plate group, with extremely significant differences (χ2=3.947 2, P < 0.05). The overall incidence of complications in intramedullary nail group was significantly lower than that in the plate group, with extremely significant difference (χ2=11.977 9, P < 0.01). Besides, the Neer scores of shoulder joint and the Mayo scores of elbow joint between the two groups had no statistically significant difference (χ2=0.235 4, 0.273 0, P > 0.05). Both intramedullary nail and plate fixations show good clinical effect in treatment of adult humeral shaft fracture, and each technique has their advantages and disadvantages, we should choose the proper technique according to the patient’s condition.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

全文链接：

Key words: Humerus, Fractures, Bone, Bone Nails, Internal Fixators, Fracture Healing

CLC Number:

R318

Feng Tao. Fixation with intramedullary nail and plate in the treatment of adult humeral shaft fracture: comparison of radial nerve injury and non-union rate[J]. Chinese Journal of Tissue Engineering Research, 2015, 19(13): 2086-2090.

Figures/Tables 3

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