Posterior Dual Plating for Distal Shaft Fractures of the Humerus

Chul-Hyun Cho; Kwang-Yeung Jeong; Beom-Soo Kim

doi:10.12671/jkfs.2017.30.3.117

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Cho, Jeong, and Kim: Posterior Dual Plating for Distal Shaft Fractures of the Humerus

Original Article

Journal of the Korean Fracture Society 2017; 30(3): 117-123.

Published online: 21 July 2017

DOI: https://doi.org/10.12671/jkfs.2017.30.3.117

Posterior Dual Plating for Distal Shaft Fractures of the Humerus

Chul-Hyun Cho, M.D., Ph.D.

, Kwang-Yeung Jeong, M.D., Beom-Soo Kim, M.D.

Department of Orthopedic Surgery, Keimyung University School of Medicine, Daegu, Korea.

Correspondence to: Chul-Hyun Cho, M.D., Ph.D. Department of Orthopedic Surgery, Keimyung University School of Medicine, 56 Dalseong-ro, Jung-gu, Daegu 41931, Korea. Tel: +82-53-250-7729, Fax: +82-53-250-7205, oscho5362@dsmc.or.kr

Received 22 November 2016 Revised 22 January 2017 Accepted 12 June 2017

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the results and efficacy of posterior dual plating for distal shaft fractures of the humerus.

Materials and Methods

We retrospectively analyzed 12 patients, who underwent open reduction and internal fixation using posterior dual plating for distal shaft fractures of the humerus, between July 2007 and July 2015, with at least 6 months of follow-up. After locating the radial nerve without dissection via posterior triceps splitting, the fracture was stabilized using a short 3.5 mm locking compression plate. Then additional fixation, using a long 3.5 mm locking compression plate, was performed. The clinical outcomes were assessed in accordance with the Mayo Elbow Performance Index (MEPI) scoring system, and the radiological outcomes were assessed using serial plain radiographs.

Results

Eleven patients (91.7%) had bony union, and the mean union period was 13.9 weeks. In one patient, delayed union was treated by autogenous iliac bone graft at 8 months after surgery, which resulted in bony union. The mean MEPI score was 95.8, and the clinical outcomes were excellent in 9 patients and good in 3 patients. Postoperative complications included 1 elbow stiffness by heterotopic ossification and 1 temporary radial nerve palsy. One patient with temporary radial nerve palsy was completely recovered within the first 4 days after surgery.

Conclusion

Posterior dual plating for distal shaft fractures of the humerus revealed satisfactory clinical and radiological outcomes. It can be a useful alternative to provide stable fixation without the need for a dissection of the radial nerve.

Keywords: Distal humerus, Fracture, Posterior approach, Dual plating

Figures and Tables

Fig. 1

Preoperative drawing on an anteroposterior plain radiograph.

Fig. 2

(A) Radiographs at the time of initial trauma show spiral distal shaft fracture of the left humerus. (B) Postoperative radiographs show anatomical reduction and stable fixation using posterior dual plating. (C) Radiographs at 10 weeks after surgery show bony union.

Fig. 3

(A) Radiographs at the time of initial trauma show transverse distal shaft fracture of the left humerus. (B) Postoperative radiographs show posterior dual plating. (C) Radiographs at 8 months after the surgery show delayed union. (D) Radiographs at the final follow-up show bony union.

Table 1

Demographic and Clinical Data

Case No.	Age (yr)	Sex	Injury mechanism	OTA classification	Union (wk)	Followup (mo)	Elbow ROM (°)	MEPI score	Clinical outcome	Complication
1	26	M	TA	12-A3	9	89	5-140	100	Excellent	-
2	21	F	TA	12-A3	48	87	0-140	100	Excellent	Delayed union
3	40	F	TA	12-B1	14	69	10-140	85	Good	-
4	20	M	Arm wrestling	12-C1	7	18	0-140	100	Excellent	-
5	24	M	Traction	12-A1	12	16	0-140	100	Excellent	-
6	25	M	Arm wrestling	12-A1	10	16	0-140	100	Excellent	-
7	26	M	Pitching	12-A1	12	15	0-140	85	Good	Temporary radial nerve palsy
8	81	F	TA	12-A1	16	12	10-130	100	Excellent	-
9	23	F	Slip down	12-C1	16	51	0-130	100	Excellent	-
10	75	F	TA	12-A2	21	84	40-110	80	Good	Elbow stiffness
11	63	F	Slip down	12-B1	16	7	0-140	100	Excellent	-
12	29	M	Slip down	12-A3	20	20	0-140	100	Excellent	-

OTA: Orthopaedic Trauma Association, ROM: range of motion, MEPI: Mayo Elbow Performance Index, M: male, F: female, TA: traffic accident.

Notes

^{Financial support} None.

^{Conflict of interests} None.

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ORCID iDs

Chul-Hyun Cho
https://orcid.org/0000-0003-0252-8741

Beom-Soo Kim
https://orcid.org/0000-0002-8728-512X

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