Compression nailing versus compression plating for management of diaphyseal fractures of the humerus: A prospective...

Compression plate osteosynthesis is the preferred treatment for diaphyseal humerus fractures. In contrast, intramedullary interlocking nailing offers many advantages but lacks in providing compression across the fracture site. We aimed to do a prospective cohort study to compare the compression plating (CP) technique with the novel compression nailing (CN) technique for diaphyseal humeral fractures.

The study was performed with a total of 32 patients included in the study, who were further divided into two groups: Group CN (n = 16) and Group CP (n = 16). An external compression device was used along with a standard antegrade humeral nailing system to achieve compression across the fracture site. The Rodriguez-Merchan criteria and the American Shoulder and Elbow Surgeons (ASES) score at six months were used for the functional evaluation in these patients.

In this study cohort, the mean age was 35 ± 12.02 years. The total mean operative time was 85.86 ± 10.62 min for Group CN and 87.69 ± 3.82 min for Group CP (p value = 0.48, student 't' test), and the total mean blood loss during surgery was 81.25 ± 9.21 ml for Group CN and 202.88 ± 16.86 ml for Group CP (p value = 0.001, student 't' test). The mean duration of follow-up in Group CN was 31.31 ± 7.99 weeks, while in Group CP it was 31.56 ± 7.30 weeks. According to Rodriguez-Merchan criteria, 12 had (75 %) excellent, three (18.75 %) had moderate, and one (6.25 %) had poor results. Whereas in Group CP, there were 13 (81.25 %) excellent results, two (12.5 %) moderate results, and one (6.25 %) poor result (p-value = 0.887, chi-square test).

The compression nailing group was found to have an upper hand in terms of significantly less blood loss and less soft tissue dissection required as compared to compression plating. With compression nailing, we were able to achieve controlled compression across the fracture site.