Outcomes of intramedullary nailing versus plate fixation for humeral shaft fractures: a retrospective cohort study

<h3>Background</h3><p dir="ltr">Humeral shaft fractures account for 1–3% of all bone fractures. Conservative treatment often leads to complications such as non-union and shoulder stiffness. Surgical fixation with a dynamic compression plate (DCP) has been the gold standar...

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Main Author: Jawad Derbas (14150664) (author)
Other Authors: Isam Moghamis (14150247) (author), Osama Alzobi (14150292) (author), Amgad Elshoeibi (22330450) (author), Abdullah Murshid (14146728) (author), Ghalib Ahmed (14146800) (author)
Published: 2025
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_version_ 1864513538100297728
author Jawad Derbas (14150664)
author2 Isam Moghamis (14150247)
Osama Alzobi (14150292)
Amgad Elshoeibi (22330450)
Abdullah Murshid (14146728)
Ghalib Ahmed (14146800)
author2_role author
author
author
author
author
author_facet Jawad Derbas (14150664)
Isam Moghamis (14150247)
Osama Alzobi (14150292)
Amgad Elshoeibi (22330450)
Abdullah Murshid (14146728)
Ghalib Ahmed (14146800)
author_role author
dc.creator.none.fl_str_mv Jawad Derbas (14150664)
Isam Moghamis (14150247)
Osama Alzobi (14150292)
Amgad Elshoeibi (22330450)
Abdullah Murshid (14146728)
Ghalib Ahmed (14146800)
dc.date.none.fl_str_mv 2025-02-07T03:00:00Z
dc.identifier.none.fl_str_mv 10.1007/s00590-025-04181-z
dc.relation.none.fl_str_mv https://figshare.com/articles/journal_contribution/Outcomes_of_intramedullary_nailing_versus_plate_fixation_for_humeral_shaft_fractures_a_retrospective_cohort_study/30233968
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Biomedical and clinical sciences
Clinical sciences
Humerus shaft
Fracture
DCP
IMN
Functional outcome
dc.title.none.fl_str_mv Outcomes of intramedullary nailing versus plate fixation for humeral shaft fractures: a retrospective cohort study
dc.type.none.fl_str_mv Text
Journal contribution
info:eu-repo/semantics/publishedVersion
text
contribution to journal
description <h3>Background</h3><p dir="ltr">Humeral shaft fractures account for 1–3% of all bone fractures. Conservative treatment often leads to complications such as non-union and shoulder stiffness. Surgical fixation with a dynamic compression plate (DCP) has been the gold standard treatment. Intramedullary nailing (IMN) has recently gained popularity due to its minimally invasive approach and reduced risk of radial nerve injury. This study aims to compare the outcomes of IMN and plate fixation for humeral shaft fractures.</p><h3>Methods</h3><p dir="ltr">This retrospective study included patients with humeral shaft fractures treated with either IMN or DCP fixation at Hamad General Hospital between April 2015 and October 2018. Patient demographics, fracture characteristics, surgical outcomes, and complications were collected. Descriptive statistics were used to summarize patient information, and univariate analysis was conducted to compare both groups. A Cox proportional hazards model, adjusted for age, gender, and polytrauma status was applied to compare time to union between IMN and DCP groups.</p><h3>Results</h3><p dir="ltr">Sixty five patients (25 IMN, 40 plate fixation) were included. Non-union rates were higher in the DCP group than in the IMN group (13% vs. 4%). Reoperation rates were also higher in the DCP group (20% vs. 4%). Postoperative neuropathy rates were 4% for IMN and 10% for DCP, with neuropathy resolution significantly higher in the IMN group (92% vs. 68%). Shoulder range of motion (ROM) and pain favored the DCP group, with 98% unaffected ROM in the plate group compared to 76% in the IMN group (<i>p</i> = 0.007), and a lower incidence of shoulder pain (28% vs. 98%, <i>p</i> < 0.001). Time to union was comparable between both groups, with an adjusted hazard ratio of 1.08 (95% CI 0.62–1.90; <i>p</i> = 0.776).</p><h3>Conclusion</h3><p dir="ltr">IMN and plate fixation effectively achieved fracture union; however, plate fixation was associated with better shoulder function, reduced pain, and higher reoperation rates. IMN was linked to a lower risk of nerve injury but compromised shoulder ROM and resulted in more postoperative pain.</p><h2>Other Information</h2><p dir="ltr">Published in: European Journal of Orthopaedic Surgery & Traumatology<br>License: <a href="https://creativecommons.org/licenses/by/4.0" target="_blank">https://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1007/s00590-025-04181-z" target="_blank">https://dx.doi.org/10.1007/s00590-025-04181-z</a></p>
eu_rights_str_mv openAccess
id Manara2_0a86fa66cc8a07905aa5515276ee395c
identifier_str_mv 10.1007/s00590-025-04181-z
network_acronym_str Manara2
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oai_identifier_str oai:figshare.com:article/30233968
publishDate 2025
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rights_invalid_str_mv CC BY 4.0
spelling Outcomes of intramedullary nailing versus plate fixation for humeral shaft fractures: a retrospective cohort studyJawad Derbas (14150664)Isam Moghamis (14150247)Osama Alzobi (14150292)Amgad Elshoeibi (22330450)Abdullah Murshid (14146728)Ghalib Ahmed (14146800)Biomedical and clinical sciencesClinical sciencesHumerus shaftFractureDCPIMNFunctional outcome<h3>Background</h3><p dir="ltr">Humeral shaft fractures account for 1–3% of all bone fractures. Conservative treatment often leads to complications such as non-union and shoulder stiffness. Surgical fixation with a dynamic compression plate (DCP) has been the gold standard treatment. Intramedullary nailing (IMN) has recently gained popularity due to its minimally invasive approach and reduced risk of radial nerve injury. This study aims to compare the outcomes of IMN and plate fixation for humeral shaft fractures.</p><h3>Methods</h3><p dir="ltr">This retrospective study included patients with humeral shaft fractures treated with either IMN or DCP fixation at Hamad General Hospital between April 2015 and October 2018. Patient demographics, fracture characteristics, surgical outcomes, and complications were collected. Descriptive statistics were used to summarize patient information, and univariate analysis was conducted to compare both groups. A Cox proportional hazards model, adjusted for age, gender, and polytrauma status was applied to compare time to union between IMN and DCP groups.</p><h3>Results</h3><p dir="ltr">Sixty five patients (25 IMN, 40 plate fixation) were included. Non-union rates were higher in the DCP group than in the IMN group (13% vs. 4%). Reoperation rates were also higher in the DCP group (20% vs. 4%). Postoperative neuropathy rates were 4% for IMN and 10% for DCP, with neuropathy resolution significantly higher in the IMN group (92% vs. 68%). Shoulder range of motion (ROM) and pain favored the DCP group, with 98% unaffected ROM in the plate group compared to 76% in the IMN group (<i>p</i> = 0.007), and a lower incidence of shoulder pain (28% vs. 98%, <i>p</i> < 0.001). Time to union was comparable between both groups, with an adjusted hazard ratio of 1.08 (95% CI 0.62–1.90; <i>p</i> = 0.776).</p><h3>Conclusion</h3><p dir="ltr">IMN and plate fixation effectively achieved fracture union; however, plate fixation was associated with better shoulder function, reduced pain, and higher reoperation rates. IMN was linked to a lower risk of nerve injury but compromised shoulder ROM and resulted in more postoperative pain.</p><h2>Other Information</h2><p dir="ltr">Published in: European Journal of Orthopaedic Surgery & Traumatology<br>License: <a href="https://creativecommons.org/licenses/by/4.0" target="_blank">https://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1007/s00590-025-04181-z" target="_blank">https://dx.doi.org/10.1007/s00590-025-04181-z</a></p>2025-02-07T03:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1007/s00590-025-04181-zhttps://figshare.com/articles/journal_contribution/Outcomes_of_intramedullary_nailing_versus_plate_fixation_for_humeral_shaft_fractures_a_retrospective_cohort_study/30233968CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/302339682025-02-07T03:00:00Z
spellingShingle Outcomes of intramedullary nailing versus plate fixation for humeral shaft fractures: a retrospective cohort study
Jawad Derbas (14150664)
Biomedical and clinical sciences
Clinical sciences
Humerus shaft
Fracture
DCP
IMN
Functional outcome
status_str publishedVersion
title Outcomes of intramedullary nailing versus plate fixation for humeral shaft fractures: a retrospective cohort study
title_full Outcomes of intramedullary nailing versus plate fixation for humeral shaft fractures: a retrospective cohort study
title_fullStr Outcomes of intramedullary nailing versus plate fixation for humeral shaft fractures: a retrospective cohort study
title_full_unstemmed Outcomes of intramedullary nailing versus plate fixation for humeral shaft fractures: a retrospective cohort study
title_short Outcomes of intramedullary nailing versus plate fixation for humeral shaft fractures: a retrospective cohort study
title_sort Outcomes of intramedullary nailing versus plate fixation for humeral shaft fractures: a retrospective cohort study
topic Biomedical and clinical sciences
Clinical sciences
Humerus shaft
Fracture
DCP
IMN
Functional outcome