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IJHSR. 2015; 5(12): 99-105


A Prospective Study of the Outcome of Closed Intramedullary Fixation of Humeral Shaft Fractures Treated with Multiple K-Wires in Adults.

Amit Nandan Mishra, Sandhya Mishra, Shakeel Ahmad Qidwai, Varun Kumar Shrimal.

Abstract
Objective: To evaluate the feasibility and efficacy of management of fracture of shaft humerus in adults by closed reduction internal fixation with the help of long K-wires followed by immobilization for 3 weeks in splint and then guarded mobilization till fracture united.
Methods: This was a prospective longitudinal study. The subjects with fresh diaphyseal humeral shaft fractures without injury to the same limb, transverse/oblique fractures with a large butterfly fragment, comminuted fractures/segmental fragments and long oblique or spiral fracture were included in the study. Patient was taken on the table in lateral position. The general anaesthesia was given. A midline vertical incision of about 3 cms was given on the posterior aspect of distal humerus and the soft tissue dissected. Triceps was split in line with the fibres and the bone was reached.
Results: The mean age of the patients was 42.13 (13.02) years. More than half (69.6%) of the subjects were male. The RTA was among 65.2% of the subjects. The oblique with butterfly type of injury was in 30.4% of the subjects and comminuted was in 21.7%. The middle site of fracture was in 52.2% and left site of fracture was in 52.2%. The antegrade nailing was used among 69.6% of the patients. There was significant increase in the extent of union, constant score and Mayo score from 4 week to 8 and 12 week. The shoulder stiffness was among 65.2% at 4 week which became 13% at 8 and 12 week. The elbow stiffness was in 17.4% of the subjects which decreased to 13% and 8.7% at 8 and 12 week respectively.
Conclusion: The present study showed that K-wire fixation for humeral shaft fractures has distinct advantages over other conservative and over operative techniques.

Key words: Fracture, Humerus, K-wire fixation.



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