Rizwan Akram, Naeem Ahmad, Amer Aziz.
Outcome of intramedullary interlocking nail in diaphysial fracture of humerus.
J Pak Orthop Assoc Jan ;20(1):11-9.

Objective: To determine relative percentage of cases achieving union, having delayed and non-union of humeral shaft fractures after intramedullary interlocking nail. Also to, determine mean time (days) taken for union by the fracture a humerus after fixation with intramedullary interlocking nail. Study Design: Cross-sectional. Place & Duration of Study: The study was conducted in the Department of Orthopaedics and Spinal Surgery, Ghurki Trust Teaching Hospital, Jallo More, Lahore. The duration of the study was one year Patients and Methods: Thirty previously diagnosed patients having fracture of the shaft of humerus, from all socioeconomic groups, attending the orthopaedic clinic, were included in the study, after screening as inclusion criteria. Out of these 30 patients, 17 were males while 13 were females. Thirteen had closed spiral humeral shaft fractures. Five had segmental fractures. Five had Gustilo & Anderson (3 type I and 2 type II) open fractures. Five patients had established non-union following conservative treatment or treatment from local bone setters, while the remaining 2 reported with pathological fractures. Data was collected using a special proforma and was analyzed using SPSS 10.0 version. Results: Twenty-seven fractures united primarily within 180 days (upto 6 months). Two fractures had delayed union i.e. upto 270 days (from 6-9 months), one of which was bonegrafted and the other had to be dynamized. One segmental fracture went into non-union at one level, which later had to be fixed with DCP and bone-grafting. The relative percentage of cases achieving union, having delayed union, and those going into non-union, stood at 90%, 6.66% and 3.34% respectively. As 29 patients out of a total 30, having different types of humeral shaft fractures, achieved union (healed) after fixation with static intramedullary nails, we can easily conclude that the healing rate with this kind of fixation was 96.66%. The duration of fracture healing in days was categorized as follows: From 90-180 days i.e. 3-6 months - Primary union. 180 to 270 days i.e. from 6-9 months was Delayed union. More than 270 days i.e. more than 9 months was Non-union. The duration for union required by a humeral fracture after fixation with intramedullary interlocking nail was about 125 days (around 04 months). Conclusions: On the basis of our research, following conclusions can be made. 1) Static intramedullary nailing by open method is a satisfactory method and can be used effectively where image intensifier was not available with overall success rate being 90-100%. 2) The average healing period for a humeral shaft fracture is about 125 days (around 4 months).

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