Mahesh Sagar Athinarapu, Venkateswarlu Kurukunda, Nagaraju Madiga, Shyamdhar Tirumuru, Srikar Jakkala, Naveen Raj K
BACKGROUND The aim of this study was to compare the locking compression plate (LCP) over dynamic compression plate (DCP) in the management of diaphyseal fractures of the humerus. 38 patients with diaphyseal fracture of the shaft of the humerus were randomized prospectively and treated by open reduction and internal fixation with LCP or DCP. 11 patients underwent internal fixation by LCP and 27 by DCP. Fixation was done through an anterolateral or posterior approach. The outcome was assessed in terms of the union time, union rate, functional outcome, ROM and the incidence of complications. Functional outcome was assessed using the Romen’s et al series grading system. On comparing the results by tests of significance like Chi-square test, there was no significant difference in Romen’s et al scores between the two groups (P>0.05). Though the average union time and recovery of ROM was found to be better for LCP as compared to DCP, it is not statistically significant. Complications such as infection were found to be higher with DCP as compared to LCP. This study proves that LCP can be considered a better surgical option for the management of diaphyseal fractures of the humerus as it offers a short union time and lower incidence of serious complications like infection. However, there appears to be no difference between the two groups in terms of the rate of union and functional outcome. MATERIALS AND METHODS In this study, 27 patients of fracture shaft of humerus fixed by open reduction and internal fixation using dynamic compression plate were compared with 11 more patients treated by open reduction and internal fixation by locking compression plate. Functional outcome was assessed using Romen’s et al scores and radiological findings were compared at 3, 6, and 12 months postoperatively. RESULTS In patients treated by DCP, 11 patients (41%) had excellent results, 15 patients (56%) had good results and 1 patient (3%) had poor results. In patients treated by LCP, 6 patients (55%) had excellent results and 5 patients (45%) had good results. CONCLUSION LCP has been shown to be advantageous over the conventional DCP in the osteoporotic bones. In younger patients, LCP produces visible callus and allows for early mobilization of fracture because of the stability of the implant.
