Skip to main content
Erschienen in: International Orthopaedics 8/2017

01.12.2016 | Original Paper

Dual plate fixation on distal third diaphyseal fracture of the humerus

verfasst von: Jun-Ku Lee, Yun-Sung Choi, Young-Suk Sim, Dae-Sung Choi, Soo-Hong Han

Erschienen in: International Orthopaedics | Ausgabe 8/2017

Einloggen, um Zugang zu erhalten

Abstract

Introduction

Displaced unstable distal third fractures of the humeral diaphysis are treated surgically through open reduction and internal fixation. Conventionally, surgeons prefer using long plates for secure fixation; however, we performed short plate dual plating for robust fixation that required a smaller incision and less dissection through an anterior approach. In this study, we report the results of dual plating of fractures of the humeral shaft, with radiographic evidence and clinical analysis.

Methods

This retrospective study included 29 patients with distal third diaphyseal fractures of the humerus. There were 18 men and 11 women, with an average age of 43 years, and a mean follow-up period of 21.2 months. We investigated the type of fracture, plate length, number of fixed screws, and fracture union. Range of motion, Disabilities of Arm, Shoulder, and Hand (DASH) score, and complications during follow-up were analyzed for clinical results.

Results

All fractures were classified according to AO classification. We used 4.5-mm narrow locking compression plates (LCP) and 3.5-mm LCP reconstruction plates. Fracture union was achieved in all cases during the follow-up. All patients recovered favourable elbow range of motion at final follow-up. At the final follow-up, average DASH score was 10.0, and no patient showed postoperative complications.

Conclusions

Satisfactory radiographic evidence and clinical results suggest that dual plating for distal diaphyseal humeral fractures may be considered a surgical option, with the advantages of strong fixation, less invasion of soft tissue, and early rehabilitation.
Literatur
1.
Zurück zum Zitat Tytherleigh-Strong G, Walls N, McQueen M (1998) The epidemiology of humeral shaft fractures. J Bone Joint Surg (Br) 80:249–253CrossRef Tytherleigh-Strong G, Walls N, McQueen M (1998) The epidemiology of humeral shaft fractures. J Bone Joint Surg (Br) 80:249–253CrossRef
4.
Zurück zum Zitat Jawa A, McCarty P, Doornberg J, Harris M, Ring D (2006) Extra-articular distal-third diaphyseal fractures of the humerus. A comparison of functional bracing and plate fixation. J Bone Joint Surg Am 88:2343–2347. doi:10.2106/jbjs.f.00334 PubMed Jawa A, McCarty P, Doornberg J, Harris M, Ring D (2006) Extra-articular distal-third diaphyseal fractures of the humerus. A comparison of functional bracing and plate fixation. J Bone Joint Surg Am 88:2343–2347. doi:10.​2106/​jbjs.​f.​00334 PubMed
6.
Zurück zum Zitat Lee SK, Yang DS, Chang SH, Choy WS (2016) LCP metaphyseal plate fixation for fractures of the distal third humeral shaft using brachialis splitting approach. Acta Orthop Belg 82:85–93PubMed Lee SK, Yang DS, Chang SH, Choy WS (2016) LCP metaphyseal plate fixation for fractures of the distal third humeral shaft using brachialis splitting approach. Acta Orthop Belg 82:85–93PubMed
8.
Zurück zum Zitat Ellwein A, Lill H, Voigt C, Wirtz P, Jensen G, Katthagen JC (2015) Arthroplasty compared to internal fixation by locking plate osteosynthesis in comminuted fractures of the distal humerus. Int Orthop 39:747–754. doi:10.1007/s00264-014-2635-0 CrossRefPubMed Ellwein A, Lill H, Voigt C, Wirtz P, Jensen G, Katthagen JC (2015) Arthroplasty compared to internal fixation by locking plate osteosynthesis in comminuted fractures of the distal humerus. Int Orthop 39:747–754. doi:10.​1007/​s00264-014-2635-0 CrossRefPubMed
9.
Zurück zum Zitat Bucholz RW, MacQueen M, Rockwood CA, Green DP (2010) Rockwood and Green’s fractures in adults, vol 1. Wolters Kluwer/Lippincott Williams & Wilkins, Philadelphia, PA Bucholz RW, MacQueen M, Rockwood CA, Green DP (2010) Rockwood and Green’s fractures in adults, vol 1. Wolters Kluwer/Lippincott Williams & Wilkins, Philadelphia, PA
10.
11.
Zurück zum Zitat Kim SJ, Lee SH, Son H, Lee BG (2016) Surgical result of plate osteosynthesis using a locking plate system through an anterior humeral approach for distal shaft fracture of the humerus that occurred during a throwing motion. Int Orthop 40:1489–1494. doi:10.1007/s00264-015-2895-3 CrossRefPubMed Kim SJ, Lee SH, Son H, Lee BG (2016) Surgical result of plate osteosynthesis using a locking plate system through an anterior humeral approach for distal shaft fracture of the humerus that occurred during a throwing motion. Int Orthop 40:1489–1494. doi:10.​1007/​s00264-015-2895-3 CrossRefPubMed
12.
Zurück zum Zitat Adams J, Coonse G (1948) Complete rigid internal fixation by double plating fractures of long bones. Proc Inst Med Chic 17:98PubMed Adams J, Coonse G (1948) Complete rigid internal fixation by double plating fractures of long bones. Proc Inst Med Chic 17:98PubMed
16.
Zurück zum Zitat Mast J, Jakob R, Ganz R (1989) Planning and reduction technique in fracture surgery. Springer-Verlag, Berlin, New YorkCrossRef Mast J, Jakob R, Ganz R (1989) Planning and reduction technique in fracture surgery. Springer-Verlag, Berlin, New YorkCrossRef
17.
Zurück zum Zitat Archdeacon MT, Wyrick JD (2006) Reduction plating for provisional fracture fixation. J Orthop Trauma 20:206–211CrossRefPubMed Archdeacon MT, Wyrick JD (2006) Reduction plating for provisional fracture fixation. J Orthop Trauma 20:206–211CrossRefPubMed
18.
Zurück zum Zitat Kosmopoulos V, Luedke C, Nana AD (2015) Dual small fragment plating improves screw-to-screw load sharing for mid-diaphyseal humeral fracture fixation: a finite element study. Technol Health Care 23:83–92. doi:10.3233/THC-140875 CrossRefPubMed Kosmopoulos V, Luedke C, Nana AD (2015) Dual small fragment plating improves screw-to-screw load sharing for mid-diaphyseal humeral fracture fixation: a finite element study. Technol Health Care 23:83–92. doi:10.​3233/​THC-140875 CrossRefPubMed
19.
Zurück zum Zitat Ji F, Tong D, Tang H, Cai X, Zhang Q, Li J, Wang Q (2009) Minimally invasive percutaneous plate osteosynthesis (MIPPO) technique applied in the treatment of humeral shaft distal fractures through a lateral approach. Int Orthop 33:543–547CrossRefPubMed Ji F, Tong D, Tang H, Cai X, Zhang Q, Li J, Wang Q (2009) Minimally invasive percutaneous plate osteosynthesis (MIPPO) technique applied in the treatment of humeral shaft distal fractures through a lateral approach. Int Orthop 33:543–547CrossRefPubMed
20.
Zurück zum Zitat An Z, Zeng B, He X, Chen Q, Hu S (2010) Plating osteosynthesis of mid-distal humeral shaft fractures: minimally invasive versus conventional open reduction technique. Int Orthop 34:131–135CrossRefPubMed An Z, Zeng B, He X, Chen Q, Hu S (2010) Plating osteosynthesis of mid-distal humeral shaft fractures: minimally invasive versus conventional open reduction technique. Int Orthop 34:131–135CrossRefPubMed
21.
22.
Zurück zum Zitat Levy JC, Kalandiak SP, Hutson JJ, Zych G (2005) An alternative method of osteosynthesis for distal humeral shaft fractures. J Orthop Trauma 19:43–47CrossRefPubMed Levy JC, Kalandiak SP, Hutson JJ, Zych G (2005) An alternative method of osteosynthesis for distal humeral shaft fractures. J Orthop Trauma 19:43–47CrossRefPubMed
23.
Zurück zum Zitat Patel R, Neu CP, Curtiss S, Fyhrie DP, Yoo B (2011) Crutch weightbearing on comminuted humeral shaft fractures: a biomechanical comparison of large versus small fragment fixation for humeral shaft fractures. J Orthop Trauma 25:300–305CrossRefPubMed Patel R, Neu CP, Curtiss S, Fyhrie DP, Yoo B (2011) Crutch weightbearing on comminuted humeral shaft fractures: a biomechanical comparison of large versus small fragment fixation for humeral shaft fractures. J Orthop Trauma 25:300–305CrossRefPubMed
Metadaten
Titel
Dual plate fixation on distal third diaphyseal fracture of the humerus
verfasst von
Jun-Ku Lee
Yun-Sung Choi
Young-Suk Sim
Dae-Sung Choi
Soo-Hong Han
Publikationsdatum
01.12.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
International Orthopaedics / Ausgabe 8/2017
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-016-3355-4

Weitere Artikel der Ausgabe 8/2017

International Orthopaedics 8/2017 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.