Abstract

To compare the effectiveness and safety of traditional open reduction and internal fixation with intramedullary nailing in the treatment of humeral shaft fractures. Seventy-four patients with humeral shaft fractures admitted to our hospital between June 2017 and June 2022 were recruited and assigned (1:1) into a control group and a study group according to the surgical method they received. The patients in the control group were treated with the open reduction and internal fixation procedure and the patients in the study group were treated with the intramedullary nailing procedure. Patients in both groups received 10 w of post-operative medication and functional exercise as adjunctive therapy and were followed up for 1 y after discharge from hospital. The surgical efficacy, perioperative indexes, inflammatory factor indexes, pain stress indexes, functional recovery of the shoulder and elbow joint, and complications of the two groups were compared. The excellent surgical rate of the study group was significantly better than that of the control group (p<0.05); the operative time, intraoperative bleeding, incision length and fracture healing time of the study group were significantly lower than those of the control group (all p<0.05); the levels of tumor necrosis factor-alpha, interleukin-1 beta and interleukin-8 at 1 w after surgery of the study group were significantly lower than those of the control group (all p<0.05); the levels of substance P and neuropeptide Y levels were significantly lower in the study group than in the control group (all p<0.05); Neer scores and histopathology scoring system at 3 mo, 6 mo, 9 mo and 1 y after surgery were significantly higher in the study group than in the control group (all p<0.05); the incidence of postoperative complications was significantly lower in the study group than in the control group (p<0.05). Compared with the traditional open reduction and internal fixation procedure, the intramedullary nailing procedure is more effective and safer in the treatment of humeral shaft fractures. This procedure can effectively improve the perioperative indicators of patients, reduce the inflammation and pain stress response of patients, and thus promote the further recovery of the function of the shoulder and elbow joint. Full-Text | PDF