Retro-prospective Comparative Study of Functional Outcomes of Closed Humeral Shaft Fractures Treated Using Nailing or Plating

Abstract

Background: Humeral shaft fractures account for approximately 3% of all fractures and are seen both in young individuals following high-velocity trauma and elderly patients with osteoporotic bone. Although non-operative treatment has traditionally been advocated, surgical management is increasingly preferred. Two commonly used methods, intramedullary interlocking (IMIL) nailing and dynamic compression plating, remain subjects of debate.

Methods: This retro-prospective study included 36 adult patients with closed humeral shaft fractures treated with either plating (n=20) or IMIL nailing (n=16) between November 2021 and November 2024 in a tertiary care Hospital. Patients were assessed for time to union, functional outcomes using Quick DASH score, shoulder range of motion, and complications. Follow-up was conducted for a minimum of 6 months.

Results: The plating group showed a mean Quick DASH score of 11.36, while the nailing group showed 12.8 (p=0.71, not significant). Most fractures united within 12 weeks in both groups. Shoulder stiffness was more frequent in the nailing group (25%) compared with plating (10%). No infections were reported. Overall, both techniques demonstrated similar union rates and functional outcomes.

Conclusion: Dynamic compression plating and IMIL nailing offer comparable results in terms of union and function. Nailing may be associated with higher rates of shoulder stiffness, although this was not statistically significant. Larger randomized studies with longer follow-up are warranted to establish superiority.