EXPERIENCES OF SURGICAL MANAGEMENT OF FRACTURE SHAFT OF HUMERUS IN ADULTS USING ENDER NAIL

Abstract

Background: This study was conducted at the Department of Orthopaedics, I.P.G.M.E& R & SSKM Hospital, Kolkata, West Bengal, with the objective to achieve quick union and minimal soft tissue disruption, least neurovascular complications and good functional outcome. In this study, 30 patients were selected on random basis from those attending the Outpatient Department and Emergency Room, between January 2015 to August 2016, with humerus shaft fractures. Among these, 76% of the patients were in age group (<40 years) with age range 22-60 years with mean age 35 years .The male : female ratio was 6.7:1 . In our study majority (73%) of the patients have type AO 12A3 fracture .Mean duration of injury was 9.633 days. Mean duration of surgery in our study was 74.33 minutes, with range of 45-95 minutes, indicating a short operating time and minimum radiation exposure. During intraoperative period no complications and difficulties were experienced. The complications of our operative period were only 13%. Mean duration of follow up was 13.7 months with range from 9-18 months without any no loss at follow up. All fractures united. Mean duration of union was 17 weeks. In this study, 80%  patients had excellent grading, 17% have good grading and 3% had fair grading on the basis of MEPS and UCLA  score  combining shoulder and elbow functional outcome .In the present study, we dealt with the association of different parameters with respect to grading fracture pattern and type .This study showed that Ender’s nailing for closed humerus shaft fracture provided satisfactory clinical ,radiological, and functional outcome ,was minimally invasive ,had less infection rate and least neurovascular complications, thus promising a viable option for treatment of closed shaft humerus fracture.

Keywords: Closed fracture shaft Of humerus ; Adults, Minimally invasive , Ender’s Nail ; Fracture union.