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Humeral shaft fractures treated by dynamic compression plates, Ender nails and interlocking nails

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Abstract

Between January 1991 and December 2002, we treated 92 acute, displaced, closed humeral shaft fractures (AO classification type A). We used three fixation methods: dynamic compression plates (DCP) in 36 patients, Ender nails (EN) in 32 patients and interlocking nails (ILN) in 24 patients. The patients were followed for a minimum of 24 months. At one year, all fractures except two (one DCP/one ILN) had united. Patients treated with EN had shorter mean operation time, 51 (35–110) min; less mean blood loss, 70 (30–170) ml and shorter mean hospital stay, 5.8 (3–12) days. There were three iatrogenic radial nerve palsies: two in the DCP group and one in the ILN group. There was one wound infection. There were three cases with impingement of the shoulder but range of motion was restored after nail removal. For patients with multiple trauma or high operative risk, EN fixation served as a safer and faster procedure. ILN fixation offered a stable fixation via a smaller incision but more fracture comminution might happen.

Résumé

Entre janvier 1991 et décembre 2002 nous avons traité chirurgicalement 92 fractures diaphysaires humérales fermés déplacés ( classification AO type A). Nous avons utilisé trois méthodes de fixation: plaque à compression dynamique (DCP) chez 36 malades, clou de Ender (EN) chez 32 malades et clou verrouillé (ILN) chez 24 malades. Les malades ont été suivis pendant un minimum de 24 mois. Àprés un an toutes les fractures sauf deux avaient consolidé (un DCP/un ILN). Les Malades traité avec EN ont eu un temps d’opération moyen plus court, 51 (35–110) min, une perte sanguine plus faible, 70 (30–170) ml et un plus court séjour à l’hôpital , 5.8 (3–12) jours. Il y avait trois paralysies iatrogènes du nerf radial, deux dans le groupe DCP et une dans le groupe ILN. Il y avait une infection. Il y avait trois cas avec un conflit de l’épaule mais l’amplitude de mouvement a été restauré après ablation du clou. Pour les malades avec multiples traumatismes ou risque opératoire élevé, l’enclouage de Ender est une procédure plus sûre et plus rapide. L’enclouage verrouillé a permit une fixation stable par une plus petite incision, mais avec un risque plus grand de comminution de la fracture.

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Authors and Affiliations

  1. Orthopaedic Department, Kaohsiung Veterans General Hospital, 386, Ta-Chung 1st Road, Kaohsiung City, Taiwan

    Ting-Cheng Chao & Chien-Jen Hsu

  2. Orthopaedic Section, Guo-Ren Hospital, Pingtung, Taiwan

    Ting-Cheng Chao & Jui-Chang Chung

  3. Department of Anesthesia, Chang-Gung Memorial Hospital-Kaohsiung, Kaohsiung, Taiwan

    Wen-Ying Chou

  4. Department of Physical Therapy, Fooyin University, Kaohsiung, Taiwan

    Chien-Jen Hsu

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  1. Ting-Cheng Chao
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  2. Wen-Ying Chou
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  4. Chien-Jen Hsu
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Correspondence to Chien-Jen Hsu.

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Chao, TC., Chou, WY., Chung, JC. et al. Humeral shaft fractures treated by dynamic compression plates, Ender nails and interlocking nails. International Orthopaedics (SICOT) 29, 88–91 (2005). https://doi.org/10.1007/s00264-004-0620-8

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  • DOI: https://doi.org/10.1007/s00264-004-0620-8

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