Comparative Analysis of Functional and Surgical Outcomes in Humeral Shaft Fractures: Interlocking Nailing vs. Dynamic Compression Plating<b></b>

Background: Humeral shaft fractures account for about 3-5% of all fractures, with a 3.87% incidence in Bangladesh. These fractures often respond well to non-operative treatments like casts and braces due to the humerus's ability to tolerate malunion, leading to satisfactory outcomes. However, surgery is necessary for specific cases, including open, segmental, or pathological fractures, and when conservative treatment fails. Surgical options, like dynamic compression plates and interlocking nails, allow for quicker recovery but carry risks, including nerve damage and mechanical failure. Interlocking nails offer a less invasive option with better biomechanics but may cause shoulder complications. Aim of the study: This study aims to compare the functional and surgical outcomes of patients treated with dynamic compression plating versus those treated with interlocking nailing, to determine the most effective approach for managing humeral shaft fractures. Methods: This cross-sectional study in Department of Orthopaedic Surgery, Bangabandhu Sheikh Mujib Medical University, Bangladesh, conducted from [11/12/2022] to [20/12/2023], involved 60 patients with humerus diaphyseal fractures, divided into two groups: Group A (30 patients treated with dynamic compression plating) and Group B (30 patients treated with interlock nailing). Participants were selected based on strict inclusion/exclusion criteria, and informed consent was obtained. The study evaluated various clinical factors using standard surgical techniques. Data analysis was performed using SPSS software, with significance determined at p <0.05. Result: A prospective observational study at a tertiary care center involved 60 patients with humeral diaphyseal fractures, divided into two groups: 30 treated with dynamic compression plating (Group A) and 30 with interlocking nailing (Group B). Most participants were under 30, predominantly male, with no significant differences in age or gender distribution. Group B showed better blood management, while Group A had superior shoulder function but more shoulder stiffness. Both groups had similar operative times, elbow performance, and fracture union rates. Neurovascular deficits were more common in Group A. The study highlights different outcomes between the two treatment methods. Conclusion: This study evaluated clinical outcomes in patients, primarily under 30 years old, with a higher incidence in males and right-sided fractures. Dynamic compression plating led to longer surgeries, more significant blood loss, higher union rates, and more shoulder stiffness. Interlock nailing resulted in fewer neurovascular deficits but reduced shoulder function postoperatively.