FUNCTIONAL OUTCOMES OF INTRAMEDULLARY FIXATION WITH TITANIUM ELASTIC NAILS IN DIAPHYSEAL FRACTURES OF HUMERUS IN ADULTS

Main Article Content

Ahmar Ali
Mohammad Osama
Hassaan Ahmed
Muhammad farhan farhat
Muhammad khan
Bilal razzaq

Keywords

Humerus, titanium elastic nails, intramedullary fixation, diaphyseal fractures

Abstract

Objective:  This study was carried out to explore the functional outcome of intramedullary fixation with titanium elastic nails in diaphyseal fractures of humerus in adults. 


Materials and methods: This prospective observational study was carried out at the trauma centre and emergency department Quetta from January 2022 to November 2023 after taking permission from the ethical committee of the institute. Adults of both genders with diaphyseal humerus fractures presenting between the ages of 18 and 60 were included. Patients with open shaft humerus fractures, radial nerve palsy, peri-prosthetic fractures, polytrauma, pathological fractures, and refusals to undergo surgery were excluded.  All patients underwent closure reduction and titanium elastic nail internal fixation. For data analysis SPSS version 23 was used. 


Results: A total of 40 patients were enrolled in this study out of which 32(80%) were male and 8(20% were females. 34 individuals (85%) reported complete union, 4 (10%) revealed delayed union, and 2 (5%) had non-union.  According to the DASH grading method, 5(12.5%) patients had mild to moderate disability, whereas 33 (82.5%) patients showed no disability at all. In two individuals with a non-union fracture, the DASH score was not calculated. Among the various complications that we identified in our study were superficial infection 15(37.5%), followed by delayed union 10 (25%) elbow stiffness 10(25%) and non-union 5(12.5%). 


Conclusion: The current study evaluated that management of diaphyseal humerus fracture with titanium elastic nail system was a safe and good choice for fixation. The use of titanium elastic nail systems to treat diaphyseal humerus fractures is minimally invasive, union is effected without altering the biology of the fracture site, and there is a decreased risk of iatrogenic radial nerve damage especially AO Type 12. A1, A2, A3).When choosing this approach, it vital to consider the type of fracture.

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References

1. Sahu RL, Ranjan R, Lal A. Fracture union in closed interlocking nail in humeral shaft fractures. Chin Med J .2015; 128: 1428-32.
2. Sahu RL, Ranjan R, Lal A. Fracture union in closed interlocking nail in humeral shaft fractures. Chinese MedJ. 2015; 128: 1428-32.
3. Clement ND. Management of humeral shaft fractures; non-operative versus operative. Arch Trauma Res. 2015; 4; e28013.
4. Gupta SV, Kumar KM,Reddy KR, Prasad SG, Gopichand K. Comparative study of management of humeral diaphyseal fractures by DCP plate and IMIL nail. J Evol Med Dent. 2014; 3: 1782-9.
5. Uhthoff HK, Poitras P, Backman DS. Internal plate fixation of fractures: short history and recent developments. J Orthop Sci. 2006; 11: 118-26.
6.Rawa S, Farooq M, Singh S, Wani M, Bhat M, Hussain A. Results of ante grade humeral interlocking nailing in adults–a prospective study. Int J Surg. 2009: 24.
7.Wali MG, Baba AN, Latoo IA, Bhat NA, Baba OK, Sharma S. Internal fixation of shaft humerus fractures by dynamic compression plate or interlocking intramedullary nail: a prospective, randomized study.STLR. 2014; 9: 133-40.
8. Kivi MM, Soleymanha M, Haghparast-Ghadim-Limudahi Z. Treatment outcome of intramedullary fixation with a locked rigid nail in humeral shaft fractures. Arch Bone Jt Surg. 2016; 4: 47-9.
9. Wang J-P, Shen W-J, Chen W-M, Huang C-K, Shen Y-S, Chen T-H. Iatrogenic radial nerve palsy after operative management of humeral shaft fractures. J Trauma Acute Care Surg. 2009; 66: 800-3
10. Manjappa C, Rohit G. Elastic intramedullary nailing of pediatric forearm fractures. J Rec Sci Tech. 2014; 11:351-4.
11. Sarwar F, Saeed HS, Iqbal S, Fayez I. Humeral diaphyseal fracture.TPMJ. 2017; 24: 1914-20.
12. Gupta SK. Assessment of cases of humerus fracture: A retrospective study. Int J Orthop Sci.2019; 5: 407-9.
13. Carroll EA, Schweppes M, Langfitt M, Miller AN, Halvorson JJ. Management of humeral shaft fractures. JAAOS. 2012; 20: 423-33.
14.Canavese F,Marengo L, Cravino M, Giacometti V, Pereira B, Dimeglio A,et al.Outcome of Conservative Versus Surgical Treatment of Humeral Shaft Fracture in Children and Adolescents: Comparison Between Non-operative Treatment (Desault's Bandage), External Fixation and Elastic Stable Intramedullary Nailing. J Pediatr Orthop. 2017; 37: e156-e63.
15. Yousaf MN, Din S, Akram MR, Yasin A, Khan RDA. Outcome of Dynamic Compression Plating in Fracture Shaft of Humerus. Ann Punjab Med Coll. 2014; 8: 34-9.
16. Naveen P, Chaitanya P. Comparative study between the dynamic compression plating (DCP) and the intramedullary interlocking nailing in diaphyseal fractures of the humerus in adults. J Evol Med Dent.2013; 2: 8704-13.
17. Verma A, Kushwaha SS, Khan YA, Mohammed F,Shekhar S, Goyal A. Clinical outcome of treatment of diaphyseal fractures of humerus treated by titanium elastic nails in adult age group. Journal of clinical and diagnostic research: JCDR. 2017; 11: RC01