Lateral Approach for Internal Fixation of the Distal Humeral Shaft Fractures

Introduction: The humerus is subjected to substantial amount of torsional stress. Conventional plating may not address this sufficiently and may lead to fixation failure or non-union. A helical plate may offer the solution. We present the surgical technique and functional outcome of 5 cases of humeral shaft fractures treated with this technique in a minimally invasive way. Materials and Methods: The operations were performed between 2004 and 2010, by three surgeons. All the patients had closed humeral shaft fractures, either simple transverse or with mild comminution. Two small incisions were made. The proximal incision was placed along the deltopectoral groove over the shaft, and the distal incision was placed as in an antero-lateral approach. The radial nerve was identified and protected. A pre-selected plate was contoured and introduced in the submuscular plane. The plate was placed in a proximal-lateral and distal-anterior position. Screws were inserted through stab incisions. The patients were followed for an average of 6 months. Functional recovery of the shoulder and elbow was assessed using the Constant and Mayo elbow performance score systems. Results: All incisions healed by first intention without complications and all the fractures went on to unite. All patients achieved good to excellent shoulder and elbow function. Conclusion: The helical plate technique is a safe and effective method of treating humeral shaft fractures and has good functional outcome.

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Outcome of radial nerve injury associated with fracture humeral shaft fractures treated with open reduction and internal fixation

International Journal of Orthopaedics Sciences ◽

10.22271/ortho.2018.v4.i2c.22 ◽

2018 ◽

Vol 4 (2c) ◽

pp. 151-154

Author(s):

Shrivastava Pradeep ◽

Jain saurabh ◽

Gautam Vaibhav

Keyword(s):

Internal Fixation ◽

Nerve Injury ◽

Radial Nerve ◽

Open Reduction ◽

Humeral Shaft ◽

Humeral Shaft Fractures ◽

Shaft Fractures ◽

Radial Nerve Injury

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Secondary radial nerve palsy after internal fixation of humeral shaft fractures

European Journal of Orthopaedic Surgery & Traumatology ◽

10.1007/s00590-013-1197-y ◽

2013 ◽

Vol 24 (3) ◽

pp. 331-333 ◽

Cited By ~ 18

Author(s):

Xun Wang ◽

Ping Zhang ◽

Youqing Zhou ◽

Chunping Zhu

Keyword(s):

Internal Fixation ◽

Radial Nerve ◽

Nerve Palsy ◽

Humeral Shaft ◽

Radial Nerve Palsy ◽

Humeral Shaft Fractures ◽

Shaft Fractures

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Assessment of Shoulder Function after Internal Fixation of Humeral Diaphyseal Fractures in Young Adults: A Prospective Comparative Study

Advances in Orthopedics ◽

10.1155/2021/9471009 ◽

2021 ◽

Vol 2021 ◽

pp. 1-6

Author(s):

Hossam Fathi Mahmoud ◽

Ahmed Hatem Farhan ◽

Fahmy Samir Fahmy

Keyword(s):

Young Adults ◽

Blood Loss ◽

Internal Fixation ◽

Operative Time ◽

Shoulder Function ◽

Humeral Shaft ◽

Humeral Shaft Fractures ◽

Shaft Fractures ◽

Group A ◽

Group B

Background. Humeral shaft fractures are commonly encountered in casualties. There are different methods of operative internal fixation with no consensus on the best technique. The objective of this study was to assess shoulder function and rate of complications among two different options of fixation, intramedullary nailing, and minimal invasive plate osteosynthesis (MIPO) in young adults. Methods. Forty-two patients with humeral shaft fractures were included in the study and divided into two equal groups: group A treated with antegrade intramedullary locked nails (IMN) and group B with MIPO. Fracture union was evaluated with serial X-rays, and shoulder function was assessed in both groups using the scale of the American Shoulder and Elbow Surgeons (ASES), University of California at Los Angeles Shoulder Scale (UCLA), and visual analog score (VAS). The mean differences between groups were recorded and considered significant if the P value was ˂0.05. Results. The results were reported prospectively with no significant differences in mean age, sex, side of injury, type of fracture, mechanism of injury, and the follow-up period between the groups studied. Group A had shorter operative time and minimal blood loss than group B. Regarding shoulder function scores (ASES, UCLA, and VAS), the results in the MIPO group were better than the IMN group with shorter time of union and fewer complications. Conclusion. Despite a shorter operative time and lower blood loss during locked intramedullary nail fixation in the management of humeral shaft fractures, MIPO enables more superior shoulder function with better fracture healing and lower morbidities.

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