Study on Percutaneous Intramedullary Nailing In Adult Diaphyseal Humeral Fractures
Mohsin Aijaz Soomro
Suleman Roshan Medical Collage Tando Adam Pakistan.
Ajmal Khan Silro
Dibba Hospital Fujairah, United Arab Emirates.
Raheel Akbar Baloch
Liaquat University Hospital, Hyderabad, Pakistan.
Najeeb Ur. Rehman
Peoples University of health and Sciences for Women, Nawabshah, Pakistan.
Muhammad Faraz Jokhio
Liaquat University of Medical and Health Science, Jamshoro, Pakistan.
Niaz Hussain Keerio *
Muhammad Medical College and Hospital, Mirpurkhas, Pakistan.
Syed Shahid Noor
Liaquat National Hospital and medical College Karachi, Pakistan.
*Author to whom correspondence should be addressed.
Abstract
Objective: The objective of this research was to evaluate close fixation techniques for fractures of humerus via percutaneous intramedullary nailing.
Methodology: This was a prospective study, carried out in Suleman Roshan Medical College Tando Adam Pakistan from January 2019 to January 2020. About 60 patients with humeral shaft fractures were made part of this study with a follow-up period of about 1 to 2 years. The inclusion criteria were humeral fractures that were of less than 7 days prior to surgery, the displacement of fracture >20° in sagittal as well as coronal plane, and the distance measuring >2cm between the two fragments. All patients were treated via the closed fixation technique. Multiple nails that were slender as well as flexible (3-5) were used in the close fixation technique including rush nails (45 patients) and ender nails (15 patients). All the patients within their follow-up periods were evaluated for ROM, pain, or any kind of deformity, and all the patients were assessed radiographically to check the process of bone union.
Results: The outcome was analyzed before implant i.e at six months and after the implant was removed. About 86% patients (n= 52) revealed satisfactory outcomes at six months. About 5 patients revealed non-union or delayed union that was healed after 2nd surgery of bone grafting in 3 patients and injections associated with bone marrow in 2 patients. Stiffening of the shoulder was found to be a frequent complication that decreased significantly when the position of nail insertion was changed during the research.
Conclusion: The technique of intramedullary nailing displayed many benefits including minimum tissue stress, a quick surgery time, decreased period of hospital stay, and rapid bone union.
Keywords: Intramedullary nails, percutaneous intramedullary nailing, diaphyseal humeral fractures, humeral shaft fractures