Outcomes of Intramedullary Nailing Versus Plate Fixation of Humerus Shaft Fractures: A Single-Center Retrospective Study.

Abstract

The optimal fixation method for humeral shaft fractures remains a topic of debate. Intramedullary nailing (IM nailing) and plate fixation are the most common surgical options, each with distinct advantages and complications. This study aimed to compare the functional outcomes and complications associated with IM nailing and plating fixation for humeral shaft fractures at Sultan Qaboos University Hospital. This retrospective cohort study included adults who underwent humeral shaft fracture fixation from January 2012 to December 2022. Patients were treated with either IM nailing or plate fixation. Outcomes that were measured included time to union, operative time, complications rate, and the abbreviated form of the Disabilities of the Arm, Shoulder, and Hand (DASH) score. About 73 patients were included in the study, 37 of whom underwent IM nailing, and 36 patients had plate fixation. There were no statistically significant differences in any of the measured outcomes: surgical site infection (<i>p</i> = 0.475), operative time (<i>p</i> = 0.365), time to union (<i>p</i> = 0.055), delayed union (<i>p</i> = 0.325), nonunion (<i>p</i> = 0.491), revision procedures (<i>p</i> = 0.254), and postoperative radial nerve injury (<i>p</i> = 1.000). The Quick DASH scores were similar between the two groups (<i>p</i> = 0.443). In conclusion, both IM nailing and plating fixation are effective methods for treatment of humerus shaft fractures with no statistically significant differences. The Nail group showed not only a trend of slightly shorter time to union but also a higher rate of complications. The Plate group had a higher incidence of delayed union but fewer cases of postoperative complications. Surgical choice should be individualized based on patient and fracture characteristics.