title: Postoperative malrotation of humeral shaft fracture after plating compared with intramedullary nailing.
abstract: OBJECTIVE
  We supposed difference of rotation alignment of postoperative humeral shaft fracutres between open reduction and internal fixation (ORIF) and intramedullay nailing (IMN) could be identified and the difference might influence the involved shoulder. This study evaluated and compared the extent of malrotation and shoulder function after humeral shaft fractures treated operatively with IMN or ORIF.
  
  
  METHODS
  Fifty humeral shaft fractures were randomly allocated into 2 groups. Group I underwent antegrade IMN and group II underwent ORIF. Malrotation was measured postoperatively by computed tomography scan (CT). Fracture union and functional outcomes were recorded at 12 months.
  
  
  RESULTS
  The final analysis comprised 45 patients. Group I had lower functional scores than group II (P < .05). Internal malrotation of 20° or more (humeral head internally rotated) was found in 27.2% of group I patients, but there was no malrotation in group II. The internal and external range of motion of the involved shoulder was significantly correlated with the degree of malrotation (P < .01).
  
  
  CONCLUSIONS
  This study comprehensively evaluated the degree of malrotation using CT scanning for every patient. These data bring to light some unexpected results about poor shoulder function and degeneration after humeral shaft fracture. The study can provide baseline data for larger series and longer follow-up periods.
  
  
  CONCLUSIONS
  Patients who underwent IMN had lower functional scores and a decreased range of motion postoperatively and also had a greater degree of malrotation than the ORIF group, which had none. The degree of malrotation correlated with a decreased range of motion and may possibly be a reason for degenerative arthritis at long-term follow-up.
authors: Traumotology Department, Beijing Jishuitan Hospital, Peking University Fourth Clinical Medical College, Beijing, China.
authors: Ying
authors: Y
authors: Li
authors: Cheng
authors: C
authors: Wang
authors: Manyi
authors: M
authors: Wang
authors: Lei
authors: L
authors: Huang
authors: Qiang
authors: Q
authors: Huang
mesh_terms: D000328:Adult; D001858:Bone Nails; D001860:Bone Plates; D005260:Female; D005593:Fracture Fixation, Internal; D005594:Fracture Fixation, Intramedullary; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery*; D058430:Humeral Head / Q000002:abnormalities* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000503:physiopathology*; D011446:Prospective Studies; D016059:Range of Motion, Articular; D055815:Young Adult