Abstract
Introduction: Humeral shaft fractures are highly prevalent. These fractures can lead to complications and significantly impact quality of life. Choosing the appropriate surgery type presents challenges of high cost, and economic burden. We are investigating and comparing the outcome of Intramedullary Nailing (IMN) surgery with reaming and nailing without reaming as a treatment method for humeral shaft fractures and its outcomes.
Materials & Methods: This study was a prospective cohort study that examined patients with humerus shaft fractures in 2023. The study was conducted on nailing humeral fractures in a teaching hospital. The patients were randomly divided into two groups: One group was treated with intramedullary nailing with reaming, and the other group without reaming. The patients were monitored for pain, delayed union, non-union, infection, radial nerve palsy, and healing status at intervals of two weeks, one, three, and six months after surgery.
Results & Discussion: Sixty-nine patients including 29 in non-reamed and 40 in the reamed cases were studied. Union was observed at 11.1±3.5 weeks in non-reamed and 8.2±1.9 in reamed group, delayed union was observed in 3 of non-reamed and 2 of reamed cases. One case of non-union was in non-reamed group. In the second week of the follow-up, the reamed group reported significantly higher pain levels; however, no significant difference was observed in the 4th and 12th weeks of follow-up. There was no significant difference between the two groups regarding complications.
Conclusion: Reamed IMN of humeral fracture can reduce the union time, and helps to lower the occurrence of delayed union and non-union. However, the patients would experience more pain in few first post-surgery weeks and reaming.