Osteosynthesis of mid-distal humeral diaphyseal fracture with an anatomically precontoured extra-articular distal plate system

Abstract

Objective To evaluate the clinical outcomes of internal fixation with extra-articular distal humerus locking compression plate (LCP) for the treatment of mid-distal humerus diaphyseal fracture. Methods From December 2012 to December 2016, a cohort of 22 patients with mid-distal humerus shaft fracture were treated by open reduction and internal fixation using extra-articular distal humerus LCP. They were 14 males and 8 females with an average age of 42.7 years (range, from 18 to 86 years). According to AO classification, there were 13 cases of type 12-A, 7 cases of type 12-B, and 2 cases of type 12-C. The surgical time, intra-operative blood loss and hospital stay were recorded. The clinical outcomes were evaluated by the Mayo elbow performance score (MEPS) at the last follow-ups. Results Surgical time ranged from 46 to 95 minutes with an average of 57 minutes. The average blood loss was 220 mL (range, from 150 to 400 mL). The average hospital stay was 10.5 days (range, from 9 to 13 days). The mean follow-up was 23.8 months (range, from 6 to 48 months). Bone union was achieved in 21 cases after an average of 4.6 months (range, from 3 to 9 months), and one patient experienced bone non-union which was uneventfully healed after secondary auto platelet rich plasma (PRP) graft management. The average MEPS elbow performance score was 88.2, resulting in 16 excellent, 4 fine and 2 fair cases (excellent and fine rate: 90.9%). Conclusions Since extra-articular distal humerus LCP can provide stable internal fixation, facilitating early postoperative rehabilitation, it may be considered an effective alternative osteosynthesis for mid-distal comminuted humeral diaphyseal fractures. Key words: Elbow joint; Humeral fractures; Fracture fixation, internal; Treatment outcome