Functional and radiological outcome of intramedullary interlocking nail in the treatment of fracture shaft of humerus

Author(s): Dr. D. Vimal Raj and Dr. Anish Anto Xavier

Abstract: Fracture shaft of Humerus are one of the most common injuries of the arm caused by high velocity injury. Both direct and indirect forces act on it resulting in different fracture patterns. Based on the pattern humeral shaft fractures have been treated both by operative and nonoperative methods. Closed intramedullary nailing of these fractures has been the modality of choice for both segmental and communited fractures compared to plate and screw fixation. By this closed nailing procedure fracture complication, operative and post operative complications are reduced with good functional outcome and early restoration of pre morbid functions. The main purpose of the study was to evaluate the functional outcome and the role of locked intramedullary nailing in fracture shaft of humerus with respect to bone union, shoulder function and related complications. A study population was selected and was carried out with a total of 25 patients (male: 20, female: 5) treated with with intramedullary interlocking nail. The inclusion criteria were patients with closed humerus fracture less than 2 weeks and age more than 20 years. The selected patients were assessed both clinically and radiologically at regular intervals of 6 wks, 12 wks, 24 wks and 6 months thereafter till union. The functional outcome was accessed using Constant murley's scoring system. From our selected study sample we found majority of the patients had segmental fractures (70%) and others had communited fractures (30%). Based on the union, 80 % of patients showed full union by 12 weeks and 20 % showed full union by 16 to 20 weeks. We had 20 patients with excellent functional outcome at final follow-up while 5 patients had good outcome. Intramedullary interlocking nail is a quite safe, effective procedure associated with fast healing, good shoulder movements and reduced infection rates in humeral shaft fractures. Being a closed intramedullary procedure early mobilization and rehabilitation is possible with early restoration of premorbid functions.

DOI: https://doi.org/10.22271/ortho.2018.v4.i1k.109