Comparative Analysis of Radiological and Functional Outcomes in Humeral Shaft Fractures Treated with Interlocking Nailing and Plate Osteosynthesis: A Randomized Controlled Trial (Code-T0270)

Introduction: Humeral shaft fractures are common long bone injuries resulting from high-energy trauma or falls. Surgical management includes intramedullary (IM) nailing and plate osteosynthesis, each with its advantages and limitations. This study aims to compare the radiological and functional outcomes of both techniques to determine the optimal treatment approach.

Aims and Objectives:

1. To compare the functional outcome of humerus shaft fracture treated with interlocking nail v/s osteosynthesis plating.
2. To assess the indications for interlocking nail and osteosynthesis plating in humerus shaft fracture.

Methods: This prospective randomized controlled trial was conducted at Sanjay Gandhi Institute of Trauma and Orthopedics, Bangalore. Forty patients with midshaft humeral fractures were randomly assigned to either IM nailing or plate osteosynthesis. IM nailing was performed using a deltoid-splitting approach, while plating was done using a posterior approach. Postoperative evaluations were conducted at 6 and 12 months using Rodriguez-Merchan criteria to assess functional outcomes. Statistical analysis was performed using SPSS v22.0.

Results: Both techniques demonstrated comparable union rates (95%). Plate osteosynthesis showed faster fracture union and better shoulder mobility but had a higher risk of radial nerve injury. IM nailing offered minimal soft tissue disruption but was associated with rotator cuff impingement and restricted shoulder movement.

Conclusion: While both methods effectively manage humeral shaft fractures, plate osteosynthesis provides better functional outcomes at the cost of increased nerve injury risk. IM nailing is preferable for cases requiring minimal soft tissue exposure. A patient-specific approach is recommended.

Keywords: Humeral shaft fracture, Intramedullary nailing, Plate osteosynthesis, Fracture healing, Shoulder mobility, Radial nerve injury