Comparison of Dynamic and Locking Compression Plates in Humeral Shaft Fractures

Objectives: To compare the functional outcome of shoulder in humeral shaft fractures fixed with dynamic compression plate versus locking compression plate. Design: This was an RCT (randomized controlled trial). Study Settings: It was conducted at the Orthopedic Department of Sir Ganga Ram Hospital Lahore over 1 year from March 2018 to February 2019. Study Procedure: This study involved 62 both male and female patients aged between 18-60 years presenting in orthopedic emergency with humeral shaft fracture. These patients were assigned into two treatment groups randomly. Fracture in Group-A was fixed with dynamic compression plate while locking compression plate was used in Group-B. Outcome variable was functional shoulder outcome which was assessed after 12 weeks of treatment using Modified Constant and Murley Score. An informed written consent was gained from every patient. Results: The mean age of the patients was 42.6 +/- 12.7 years. There were 45 (72.6%) male and 17 (27.4%) female patients in the study group with a male to female ratio of 2.6:1. The mean BMI of these patients was 27.9 +/- 3.4 Kg/m(2) and 17 (27.4%) patients were obese. Left side was more frequently involved (53.2%) as compared to the right side (46.8%). Upon follow-up, the Modified Constant and Murley score was significantly higher in patients treated with DCP as compared to LCP (91.3 +/- 7.4 vs. 85.8 +/- 8.3; p-value=0.008). The frequency of excellent functional shoulder outcome was significantly higher in patients treated with DCP as compared to LCP (87.1% vs. 54.8%; p-value=0.005). When stratified similar difference was observed across various subgroups of patients based on patient's age, gender, side involved, duration since injury and BMI. Conclusion: Dynamic compression plate was associated with significantly better functional shoulder outcome as compared to locking compression plate in patients with humeral shaft fractures regardless of patient's age, gender, duration since injury, side involved and BMI which along with cheaper hardware cost advocates its preferred use in future practice.