J Korean Fract Soc.  2017 Jul;30(3):117-123. 10.12671/jkfs.2017.30.3.117.

Posterior Dual Plating for Distal Shaft Fractures of the Humerus

• Cho CH
• Jeong KY
• Kim BS

• KMID: 2424119
• DOI: http://doi.org/10.12671/jkfs.2017.30.3.117

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.

Keyword

Distal humerus; Fracture; Posterior approach; Dual plating

MeSH Terms

Elbow
Follow-Up Studies
Humans
Humerus*
Ossification, Heterotopic
Paralysis
Postoperative Complications
Radial Nerve
Retrospective Studies
Transplants

Figure

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  Fig. 1 Preoperative drawing on an anteroposterior plain radiograph.

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  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.

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  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.

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