Fixation of extra-articular distal humerus fractures with a single posterolateral plate
Background: Our study aimed to establish that use of a single posterolateral plate for the open reduction and internal fixation of extraarticular metaphyseal humerus fractures resulted in consistent fracture healing, good functional outcomes and low complication rates.
Methods: A retrospective study was conducted at the Department of Orthopaedics, Northdale Hospital, Pietermaritzburg. A review of case X-rays and patient files from 1 January 2015 to 30 November 2017 of all patients who underwent operative intervention for extra-articular metaphyseal distal humeral fractures was undertaken. Standardised radiographs, functional assessment criteria (Quick Disabilities of the Arm, Shoulder and Hand Score – QuickDASH Score) and post-operative complications recorded in the patients’ charts were analysed.
Results: Fifteen patients were included in the study. Ten male patients and five female patient’s charts were analysed. The mean age of the participants was 33.13 years. All 15 patients showed adequate fracture healing on X-ray involving three or four cortices of the fracture site. There was no post-operative loss of fracture fixation. The mean humeral metaphyseal–diaphyseal angle was 84°, mean humeral–ulnar angle was 18°, mean shaft condylar angle was 40.4°, and the mean percentage of the capitellum anterior to the anterior humeral line was 49.3 per cent. The mean duration of surgery was 95.4 minutes. The mean QuickDASH score was 19.39.
Conclusion: The use of a single posterolateral plating system for the fixation of extra-articular distal humeral fractures provides a viable alternative to dual plating. This method of fixation provided adequate stability of fracture fixation, good functional outcomes, low complication rates, shorter surgical times and less soft tissue dissection. This study supports current published evidence in this regard.
Level of evidence: Level 4