Korean J Sports Med.  2016 Dec;34(2):120-126. 10.5763/kjsm.2016.34.2.120.

Comparison of the Result of the Intramedullary Nail Fixation and Plate Fixation in Humeral Shaft Fracture with Butterfly Fragments

Affiliations
  • 1Department of Orthopedic Surgery, Konkuk University Chungju Hospital, Konkuk University School of Medicine, Chungju, Korea. stompower@hanmail.net

Abstract

First aim of this study was to compare the results of the intramedullary nail fixation and plate fixation for the management of humeral shaft fracture with butterfly fragments. Second aim of this study was to appraise the necessity of anatomical reduction and fixation for butterfly fragment in humeral shaft fracture. Thirty-one patients with comminuted humeral shaft fracture were treated by reduction and internal fixation with intramedullary nail or plate. The criteria for inclusion were AO classification type B, follow-up period more than 12 months, diaphyseal fracture without involvement of joints. Eighteen patients underwent intramedullary nail fixation and 13 by plate fixation. The outcome was assessed in terms of the union rate, union time, incidence of complications, and functional outcome of shoulder joint. The union rate was 94.4% in intramedullary nail group and 100% in plate group. The average union time was found to be no significant difference between two groups (p>0.05). There was no significant difference in the American Shoulder and Elbow Surgeons' score and range of motion of shoulder and elbow joint between the two groups in last follow-up (p>0.05). The union rate and average union time and functional outcome of shoulder joint was no significant difference between the intramedullary nail fixation and plate fixation for the management of humeral shaft fracture with butterfly fragments. It is recommended to select skillful technique to avoid technical errors rather than technique to fix of butterfly fragments.

Keyword

Humerus; Comminuted fracture; Fracture fixation; Intramedullary; Bone plate
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