Single locking compression plate fixation of extra-articular distal humeral fractures

• Published in: Journal of orthopaedics and traumatology Vol. 16; no. 2; pp. 99 - 104
• Main Authors: Kumar, Malhar N., Ravishankar, M. R., Manur, Ravikiran
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.06.2015; Springer Nature B.V
• Subjects: Adult; Bone Plates; Bone Screws; Conservative Orthopedics; Disability Evaluation; Female; Fracture Fixation, Internal - instrumentation; Humans; Humeral Fractures - diagnostic imaging; Humeral Fractures - surgery; Male; Medicine; Medicine & Public Health; Middle Aged; Original; Original Article; Orthopedics; Prospective Studies; Radiography; Rheumatology; Sports Medicine; Surgical Orthopedics; Traumatic Surgery; Treatment Outcome; Metaphyseal fractures of humerus; Plate osteosynthesis of humerus; Distal humerus fractures; Locking compression plate
• ISSN: 1590-9921; 1590-9999
• DOI: 10.1007/s10195-014-0325-8

Background Earlier literature on fixation of distal third humeral fractures describes the use of elaborate modification of existing implants, custom-made implants and dual plating. These modifications have the disadvantages of limitations of hardware availability and cost as well as longer surgical exposure to accommodate the plates. The aim of this study was to assess the effectiveness of osteosynthesis of extra-articular diaphyseal fractures of the distal third of the humerus using a single 4.5-mm locking compression plate (LCP) with two-screw purchase in the distal fragment. Materials and methods We performed internal fixation of distal third extra-articular humeral fractures in 22 adult patients using 2–3 lag screws neutralized with a single 4.5-mm locking compression plate with only two screws in the distal fragment. The mean follow-up period was approximately 1.6 years. Results Fractures united in all 22 patients with minimal complications. The mean time to union of fracture was 13 weeks. The Mayo elbow score and the DASH scores were in the excellent and good category in all patients at final follow-up. Conclusions Our study showed that it is possible to obtain excellent outcomes in distal third fractures using only a single 4.5-mm LCP with two-screw (4-cortices) purchase in the distal fragment. The disadvantages inherent in the previous methods can be avoided with the use of the present technique. This technique obviates the need for the use of customized distal humeral implants and modified implants in most patients. Level of evidence Level IV.