COMPARATIVE OUTCOMES OF DYNAMIC COMPRESSION PLATING AND LOCKED COMPRESSION PLATING IN HUMERAL DIAPHYSEAL FRACTURES
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Keywords
Humeral shaft fractures, dynamic compression plate, locking compression plate, functional outcomes, fracture union
Abstract
Background: Humeral diaphyseal fractures are frequently encountered and often require surgical fixation for optimal functional recovery. Dynamic compression plating (DCP) and locking compression plating (LCP) are widely used techniques, but comparative evidence on their outcomes remains limited. This study aimed to compare intraoperative parameters, radiological union, functional outcomes, and complications between DCP and LCP.
Materials and Methods: A prospective comparative study was conducted on 60 patients with humeral diaphyseal fractures, equally divided into DCP (n = 30) and LCP (n = 30) groups. Baseline demographic and clinical characteristics were comparable between groups (p > 0.05). Intraoperative parameters (operative time, blood loss), radiological union (assessed by serial radiographs), functional outcome scores [Disabilities of the Arm, Shoulder, and Hand (DASH) and Mayo Elbow Performance Score (MEPS)], and complications were analyzed up to 6 months follow-up.
Results: The mean age of the cohort was 41.6 ± 11.8 years, with 38 males (63.3%) and 22 females (36.7%). Road traffic accidents were the most common mechanism of injury (55%). The mean operative time was significantly longer in the LCP group (94.3 ± 10.6 min) compared to DCP (88.2 ± 9.4 min; p = 0.02), while blood loss was comparable (p = 0.18). The mean time to radiological union was significantly shorter with LCP (15.6 ± 2.3 weeks) than DCP (17.4 ± 2.6 weeks; p = 0.01). At 6 months, union rates were high in both groups (LCP: 96.7%, DCP: 90%). Functional outcomes favored LCP, with lower DASH scores (14.8 ± 6.1 vs. 18.2 ± 6.7; p = 0.04) and higher MEPS (91.3 ± 7.4 vs. 88.1 ± 8.1; p = 0.09, not significant). Complications were slightly higher in the DCP group, including delayed/nonunion (10% vs. 0%) and implant failure.
Conclusion: Both DCP and LCP provide reliable fixation and satisfactory outcomes in humeral diaphyseal fractures. However, LCP demonstrated faster union and marginally superior functional results, with fewer complications, suggesting it may be preferable in complex fracture patterns.
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Dr. Ranadheer Reddy Taanam
Associate Professor, Department of Orthopaedics, Viswabharathi Medical College, Kurnool, Andhra Pradesh