title: [Effectiveness comparison between locking compression plate fixation and locked intramedullary nail fixation for humeral shaft fracture of types B and C].
abstract: OBJECTIVE
  To compare the effectiveness between locking compression plate (LCP) and locked intramedullary nail (IMN) for humeral shaft fractures of types B and C.
  
  
  METHODS
  Between January 2010 and January 2012, 46 patients with humeral shaft fractures of types B and C were treated, and the clinical data were retrospectively analyzed. LCP was used for internal fixation in 22 cases (LCP group), and IMN in 24 cases (IMN group). There was no significant difference in gender, age, injury causes, the side of fracture, the site of fracture, the type of fracture, associated injury, and time from injury to operation between 2 groups (P > 0.05). The regular clinical examination and evaluation of radiography were done. Shoulder function was evaluated by Neer grading system and elbow function was evaluated by Mayo elbow performance score after operation.
  
  
  RESULTS
  The operation time and intraoperative blood loss in IMN group were significantly lower than those in LCP group (P < 0.05). There was no significant difference in hospitalization time between 2 groups (t=0.344, P=0.733). All patients were followed up 16.8 months on average (range, 12-24 months). At 6 months after operation, bone nonunion occurred in 1 patient of LCP group and in 2 patients of IMN group; the bone healing rate was 95.5% (21/22) in LCP group and 91.7% (22/24) in IMN group, showing no significant difference (chi2=0.000, P=1.000). Except for nonunion patients, the bone healing time was (11.77 +/- 0.75) weeks in LCP group and (11.38 +/- 0.82) weeks in IMN group, showing no significant difference (t=1.705, P=0.095). Between LCP and IMN groups, significant differences were found in radial nerve injury (4 cases vs. 0 case) and impingement of shoulder (0 case vs. 6 cases) (P < 0.05), but no significant difference in superficial infection (1 case vs. 0 case) and iatrogenic fracture (1 case vs. 2 cases) (P > 0.05). There was no significant difference in shoulder function and elbow
  
  
  CONCLUSIONS
  LCP fixation and IMN fixation for humeral shaft function at 1 year after operation between 2 groups (P > 0.05). fractures of types B and C can achieved satisfactory results. More attention should be paid to avoiding radial nerve injury by fixation of LCP; nail tail should be buried deeply into the cortex of the greater tuberosity and rotator cuff should be protected to decrease the rate of impingement of shoulder by fixation of IMN.
authors.forename: Peng
authors.initials: P
authors.lastname: Yin
authors.forename: Zhi
authors.initials: Z
authors.lastname: Mao
authors.forename: Lihai
authors.initials: L
authors.lastname: Zhang
authors.forename: Sheng
authors.initials: S
authors.lastname: Tao
authors.forename: Qun
authors.initials: Q
authors.lastname: Zhang
authors.forename: Xiangdang
authors.initials: X
authors.lastname: Liang
authors.forename: Hao
authors.initials: H
authors.lastname: Zhang
authors.forename: Anhua
authors.initials: A
authors.lastname: Long
authors.forename: Guoqi
authors.initials: G
authors.lastname: Wang
authors.forename: Peifu
authors.initials: P
authors.lastname: Tang
mesh_terms: D000328:Adult; D000368:Aged; D001858:Bone Nails; D001860:Bone Plates; D004551:Elbow Joint / Q000503:physiopathology; D004867:Equipment Design; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation* / Q000379:methods; D017102:Fracture Healing; D006801:Humans; D006810:Humeral Fractures / Q000209:etiology / Q000601:surgery*; D016268:Internal Fixators; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011885:Radius Fractures / Q000209:etiology / Q000601:surgery; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D012785:Shoulder Joint / Q000503:physiopathology; D016896:Treatment Outcome