An Alternative Method of Osteosynthesis for Distal Humeral Shaft Fractures

Abstract

Treatment of extra-articular distal humerus shaft fractures with plating techniques is often difficult, as traditional centrally located posterior plates often encroach on the olecranon fossa, limiting distal osseous fixation. The use of a modified Synthes Lateral Tibial Head Buttress Plate (Synthes, Paoli, PA) allows for a centrally placed posterior plating of the humeral shaft that angles anatomically along the lateral column to treat far distal humeral shaft fractures. Fifteen patients treated in this manner were followed to radiographic and clinical union. There were no cases of instrumentation failure or loss of reduction.

Comparative study of three models of extra-articular distal humerus fracture osteosynthesis using the finite element method on an osteoporotic computational model

“…Indeed, in clinical practice it is not common to place the plates and so many screws so distally in extra-articular fractures of the distal humerus. [2][3][4][5][6][7]10,11 This study suggests that under physiological loads, which are common in the immediate postoperative period, the largest displacements on the joint surface are observed on the radial condyle, and the largest displacements in the gap area are observed in the front part. This information suggests that it is necessary, regardless of whether one or two plates are being placed, to achieve greater stability in the radial column area, which was also confirmed in clinical practice.…”

“…This information suggests that it is necessary, regardless of whether one or two plates are being placed, to achieve greater stability in the radial column area, which was also confirmed in clinical practice. 2,4 The significance of lateral column stabilization is all the greater if we know that in the case of osteoporosis in the distal humerus region, it is most pronounced in the posterolateral segment. 28,29 Moreover, it was found that the cortex in the medial column region is substantially stronger in comparison with the lateral column, both in the supra-and infracondylar region of the distal humerus.…”

“…Although there is still some controversy regarding the treatment of extra-articular distal humerus fractures, many surgeons recommend surgery with plates and screws, [1][2][3][4][5][6][7] while others give precedence to functional bracing, even in the case of a radial nerve lesion. 8,9 Robinson et al 1 reported a better healing response in operated patients with an extra-articular metaphyseal fracture of the distal humerus compared to patients treated non-operatively.…”

“…2,3 Distal humeral fractures have a relatively small incidence, but a large number of subtypes. 9 No prospective randomized studies have been published on their outcomes, and the majority of the studies carried out were retrospective and involved a small number of patients.…”

Técnica Mínimamente Invasiva por vía posterior para el Tratamiento de Fracturas Diafisarias del Húmero. Posterior minimally invasive plate osteosynthesis for humeral shaft fractures

“…2,3,8,9,[16][17][18][19][20][21][22][23] Algunos autores comunican similares resultados entre la TMI y la cirugía convencional con placas y tornillos. 24 La osteosíntesis abierta con placas de compresión está considerada entre los mejores métodos de tratamiento.…”