Comparison of Dynamic and Locking Compression Plates in Humeral Shaft Fractures
Safdar Iqbal, Adnan Latif Malik, Saif ur Rehman, Farhan Aslam, Muhammad Zain-ul-Abidin, Abrar-ul-Haq
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ABSTRACT
Objectives: To compare the functional
outcome of shoulder in humeral shaft fractures fixed with dynamic compression
plate versus locking compression plate.
Design: This was an RCT (randomized
controlled trial).
Study Settings: It was conducted at
the Orthopedic Department of Sir Ganga Ram Hospital Lahore over 1 year from March
2018 to February 2019.
Study Procedure: This study involved 62
both male and female patients aged between 18-60 years presenting in orthopedic
emergency with humeral shaft fracture. These patients were assigned into two
treatment groups randomly. Fracture in Group-A was fixed with dynamic
compression plate while locking compression plate was used in Group-B. Outcome
variable was functional shoulder outcome which was assessed after 12 weeks of
treatment using Modified Constant and Murley Score. An informed written consent
was gained from every patient.
Results: The mean age of the
patients was 42.6±12.7 years. There were 45 (72.6%) male and 17 (27.4%) female
patients in the study group with a male to female ratio of 2.6:1. The mean BMI
of these patients was 27.9±3.4 Kg/m2 and 17 (27.4%) patients were
obese. Left side was more frequently involved (53.2%) as compared to the right
side (46.8%). Upon follow-up, the Modified Constant and Murley score was
significantly higher in patients treated with DCP as compared to LCP (91.3±7.4
vs. 85.8±8.3; p-value=0.008). The frequency of excellent functional shoulder
outcome was significantly higher in patients treated with DCP as compared to
LCP (87.1% vs. 54.8%; p-value=0.005). When stratified similar difference was
observed across various subgroups of patients based on patient’s age, gender,
side involved, duration since injury and BMI.
Conclusion: Dynamic compression
plate was associated with significantly better functional shoulder outcome as
compared to locking compression plate in patients with humeral shaft fractures
regardless of patient’s age, gender, duration since injury, side involved and
BMI which along with cheaper hardware cost advocates its preferred use in future
practice.
Keywords: Humeral Shaft
Fracture, Locking Compression Plate, Dynamic Compression Plate, Functional
Shoulder Outcome