Surgical Mangement of the Fracture of the Humeral Shaft: A comparison using of B%ate fixation and Ender nailing

Kim, Ki Soo; Choi, Young Soo; Baik, In Kyu; Oh, Se ln

Abstract

The treatment of humeral shaft fractures remains controversal. The decision should be based on the type and location of the fracture, The presence of concomitant injuries, and the age and condition of the patient. Auhors reviewed and analyzed plate fixation in 30 patients and Ender nailing in 21 patients having humeral shaft fractures. These patients were treated at the Department of Orthopaedic Surgery, Kwang ju Christian Hospital from January 1988 to December 1993. The results were as follows, 1. Males had a dominant incidence in social active age groups, the major causes of these injuries were traffic accidents. 2. Most of surgical indications were polytrauma patients in Ender nailing groups, while flilure of conseuative management and radial nerve palsy in plate fixation groups, The bony union rate was 80.9% in Ender nailing groups and 100% in plate fixation groups. 3. Among the seven radial nerve palsy sustaining high energy accidents two cases had poor results. Nonunion of the humeral shaft fracture occured in four cases and were associated with insecure fixation, distraction of fracture site and open fracture. these four patients were only in the Ender nailing groups. When surgical management is indicated, internal fixation using plate osteosynthesis combining interfragmentary compression can give good results. Closed intramedullary Ender nailing have advantages and can be performed effectively in selected fractures of the humeral shaft such as polytrauma patients.