Comparative outcomes of dynamic compression plating and locked compression plating in humeral diaphyseal fractures: A prospective randomized study

Background: Humeral shaft fractures account for approximately 3 % of all fractures and exhibit a bimodal age distribution. Dynamic compression plating (DCP) and locked compression plating (LCP) are two principal methods for surgical fixation. However, direct comparative clinical data evaluating their relative effectiveness are limited. This study aims to compare the outcomes of DCP and LCP in the surgical treatment of acute humeral shaft fractures, with respect to union rates, functional outcomes, complications, and operative characteristics. Methods: A prospective randomized controlled study was conducted between May 2015 and May 2018 at Level-1 trauma center. Forty patients aged 18–65 years with acute humeral shaft fractures were randomly assigned to undergo fixation using either 4.5 mm DCP (Group I) or 4.5 mm LCP (Group II). Results: Both groups were demographically comparable. The mean age was 36.4 ± 12.2 years in the DCP group and 38.1 ± 11.7 years in the LCP group (p = 0.57). Union was achieved in 80 % of DCP cases and 60 % of LCP cases by four months (p = 0.09). The mean time to union was 16 ± 8.03 weeks in the DCP group and 18 ± 6.01 weeks in the LCP group. No statistically significant differences were found regarding ASES scores (p = 0.38), final elbow ROM (p = 1.00), or pain levels (p = 0.79). Conclusion: Both DCP and LCP are effective methods for internal fixation of humeral shaft fractures, with no significant differences in union rates, functional recovery, or complication profiles. Proper application of biomechanical and surgical principles, rather than implant design alone, appears to be the critical determinant of clinical outcomes.