PMID- 38371056
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240220
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 16
IP  - 1
DP  - 2024 Jan
TI  - Dynamic Compression Plating Versus Antegrade Intramedullary Nailing for the 
      Treatment of OTA/AO 12-A Fractures: A Retrospective Cohort Study.
PG  - e52472
LID - 10.7759/cureus.52472 [doi]
LID - e52472
AB  - BACKGROUND: Fractures of the humerus diaphysis are common and often result from 
      motor vehicle accidents (MVAs). Treatment methods range from nonoperative 
      approaches to various operative techniques, including antegrade intramedullary 
      nailing (AIMN) and dynamic compression plate (DCP) fixation. This study aimed to 
      compare the cost effectiveness and outcomes of plating and nailing for humerus 
      diaphyseal fractures. METHODS:  A retrospective cohort study involving 59 cases 
      of humerus diaphyseal OTA/AO 12-A fractures was conducted at King Saud Medical 
      City (KSMC), a level I trauma center located in the center region in Riyadh, 
      Saudi Arabia. Patients treated with AIMN, anterolateral plating, or posterior 
      plating were included. Data on demographics, clinical parameters, radiographic 
      healing, and costs were collected and analyzed. RESULTS: The average surgical 
      duration was shorter in the AIMN group compared to the anterolateral and 
      posterior plating groups but with no statistical significance (P > 0.05). The 
      average length of stay (LOS) was shorter, and the change in hemoglobin levels was 
      lower in the AIMN group when compared to other groups but without a statistically 
      significant difference (P > 0.05). The average cost of AIMN was significantly 
      higher than that of anterolateral and posterior plating groups (P < 0.0001). 
      CONCLUSION:  While both nailing and plating procedures are options for treating 
      OTA/AO 12-A fractures, AIMN carries a higher overall procedural cost. The 
      practice of drain placement in our study population is likely the cause of the 
      increased LOS in the plating groups. Relative additional analgesic requirements 
      were associated with AIMN. Surgeons should consider meticulous hemostasis to 
      avoid drain placement, which can decrease LOS, thus possibly decreasing 
      unnecessary treatment costs of humerus shaft fractures.
CI  - Copyright (c) 2024, Alrashedan et al.
FAU - Alrashedan, Bander S
AU  - Alrashedan BS
AD  - Orthopedic Surgery, King Saud Medical City, Riyadh, SAU.
FAU - Almalki, Mohammed M
AU  - Almalki MM
AD  - Orthopedic Surgery, King Saud Medical City, Riyadh, SAU.
FAU - Alromaih, Norah I
AU  - Alromaih NI
AD  - Orthopedics, King Saud Medical City, College of Medicine, Riyadh, SAU.
FAU - Almustanir, Bashah
AU  - Almustanir B
AD  - Orthopedic Surgery, King Saud Medical City, Riyadh, SAU.
FAU - Alyassain, Hussain M
AU  - Alyassain HM
AD  - Orthopedic Surgery, King Saud Medical City, Riyadh, SAU.
FAU - Sahli, Bandar
AU  - Sahli B
AD  - Orthopedic Surgery, King Saud Medical City, Riyadh, SAU.
LA  - eng
PT  - Journal Article
DEP - 20240117
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC10870093
OTO - NOTNLM
OT  - clinical outcomes
OT  - cost-effectiveness
OT  - dynamic compression plating
OT  - humerus diaphyseal fractures
OT  - intramedullary nailing
COIS- The authors have declared that no competing interests exist.
EDAT- 2024/02/19 06:42
MHDA- 2024/02/19 06:43
PMCR- 2024/01/17
CRDT- 2024/02/19 04:20
PHST- 2024/01/17 00:00 [accepted]
PHST- 2024/02/19 06:43 [medline]
PHST- 2024/02/19 06:42 [pubmed]
PHST- 2024/02/19 04:20 [entrez]
PHST- 2024/01/17 00:00 [pmc-release]
AID - 10.7759/cureus.52472 [doi]
PST - epublish
SO  - Cureus. 2024 Jan 17;16(1):e52472. doi: 10.7759/cureus.52472. eCollection 2024 
      Jan.