J Korean Fract Soc.  2012 Apr;25(2):155-162. 10.12671/jkfs.2012.25.2.155.

Operative Treatment of Humerus Shaft Fracture: Conventional Open Plating or Minimally Invasive Plate Osteosynthesis

• Lee HJ
• Oh CW

• KMID: 2015461
• DOI: http://doi.org/10.12671/jkfs.2012.25.2.155

Abstract

No abstract available.

MeSH Terms

Humerus

Figure

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  Fig. 1 (A, B) A 41-year-old female with segmental fracture of the humerus shaft, which is AO/OTA classification C2. (C, D) Intraoperative fluoroscopic images showing Schanz screws is inserted from the lateral sides of the greater tuberosity and lateral condyle of the humerus with the distal and proximal fragments faced anteriorly. Note that insertion point to avoid injury to the radial nerve. (E) Reduction is maintained with a unilateral external fixator. A roll of elastic bandage can be used.

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  Fig. 2 (A~D) A metaphyseal locking compression plate is inserted from the proximal incision while maintaining reduction with external fixator. The position of the plate is determined by fluoroscopy. Kirschner wires are used for provisional fixation of the plate. (E~G) Immediate postoperative radiographs showing acceptable alignment. The screws are inserted under direct visualization through the proximal and distal incisions.

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  Fig. 3 (A, B) Radiographs taken eight months after the index surgery show complete bone healing. (C~E) Minimal scar with nearly full range of motion in the shoulder and elbow joints.

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  Fig. 4 (A, B) A 61-year-old male with AO/OTA classification C2 fracture of the humerus. (C~H) The fracture is reduced and maintained by utilizing a elastic nail inserted from the lateral condyle of the humerus. (I) After making a submuscular tunnel, a locking plate is inserted. Locking drill sleeves can be used as a handle. Note that biceps brachii muscle, split medial part of the brachialis, and the cutaneous brance of the musculocutaneous nerve is retracted medially at the distal incision.

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  Fig. 5 (A~C) Immediate postoperative radiographs and picture of the surgical wound. (D, E) Radiographs show complete healing of the fracture eight months after the index surgery.

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  Fig. 6 (A, B) A 64-year-old male showed comminuted humerus shaft fracture of AO/OTA classification B3. (C~E) Indirect reduction and maintaining reduction was assisted by a unilateral external fixator. (F) A locking compression plate is introduced into submuscular tunnel.

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  Fig. 7 (A, B) Immediate postoperative radiographs show reduced fracture in anatomical alignment. (C, D) Nine months after the index surgery, radiographs show complete healing. (E, F) Minimal scar with recovered range of motion in the shoulder and elbow joints.

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  Fig. 8 (A, B) A 30-year-old male sustained simple, transverse fracture of the humerus shaft (AO/OTA classification A3). (C~F) Submuscular plating under the fluoroscopy guidance.

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  Fig. 9 (A~C) Immediate postoperative radiographs and picture of the surgical wound. Percutaneous insertion of screws is used with caution because of possible injury to the musculocutaneous nerve. (D, E) Radiographs show complete healing in anatomical alignment ten months after the index surgery.

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