Indian Journal of Orthopaedics Surgery 2023;9(3):132–146
Content available at: https://www.ipinnovative.com/open-access-journals
Indian Journal of Orthopaedics Surgery
Journal homepage: https://www.ijos.co.in/
Original Research Article
Functional outcome of diaphyseal fractures of humerus in adults treated with
closed interlocking nails: A prospective study
Somnath Ghosh
1,
*, Buddhadeb Nayak
1
, Dhananjoy Bera
1
, Swarnendu Samanta
1
1
Peerless Hospitex Hospital & BK Roy Research Centre, Kolkata, West Bengal, India
ARTICLE INFO
Article history:
Received 31-07-2022
Accepted 14-06-2023
Available online 04-09-2023
Keywords:
Fracture
Closed interlocking nail
Functional study
ABSTRACT
Background: 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.
Materials and Methods: 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.
Results: 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.
Conclusion: 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.
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1. Introduction
Humerus is a long tubular bone connecting scapula in the
shoulder and radius and ulna in the elbow. The diaphysis
is the expanse distal to surgical neck and proximal to
supracondylar ridge.
1
* Corresponding author.
E-mail address: ghoshsomnath3@gmail.com (S. Ghosh).
Diaphyseal fractures of humerus are common,
representing 3% of all fractures and 20% of all humerus
fractures.
2,3
Age distribution is bimodal, first peak in 21
to 30 years age group, mostly young males due to high
velocity trauma, and the second peak in 60 to 80 years
age group, mostly older females due to trivial trauma.
4
Most diaphyseal fractures are closed and simple, 3% to 5%
presenting as open and 8% as pathological.
5
https://doi.org/10.18231/j.ijos.2023.028
2395-1354/© 2023 Innovative Publication, All rights reserved. 132