Surgical result of plate osteosynthesis using a locking plate system through an anterior humeral approach for distal shaft fracture of the humerus that occurred during a throwing motion

Kim, Sung Jae; Lee, Sang‐Hyun; Son, Hee Jung; Lee, Bong Gun

doi:10.1007/s00264-015-2895-3

Cited by 15 publications

(10 citation statements)

References 22 publications

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“…In terms of rates of implant removal for pain relief, there was no significant difference between the anterolateral approach group (10.0%) and the posterior approach group (12.3%). Kim et al [45] reported a similar rate of implant removal (16.1%) following surgery using the anterolateral approach to that reported in the current study. However, in current study, implant removal was difficult in the posterior approach group due to scar tissue formation around the radial nerve.…”

Section: Bsupporting

confidence: 86%

Comparison of the Posterior and Anterolateral Surgical Approaches in the Treatment of Humeral Mid-Shaft Fractures: A Retrospective Study

Tian

Leng

et al. 2020

Med Sci Monit

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The aim of this study was to retrospectively assess and compare the functional outcomes and complications following anterolateral versus posterior surgical approaches for the treatment of mid-shaft fractures of the humerus. Material/Methods: This study included 107 patients treated for mid-shaft fractures between May 2015 and July 2018. Demographic and surgical data were collected for each patient. During follow-up visits, radiographs were acquired and evaluated. The clinical outcomes of the involved joints were assessed by the Constant scoring system, range of motion (ROM), and the Mayo Elbow Performance Scoring system at the 12-month follow-up. Results: The posterior approach was performed in 57 patients with type A fractures (group I, n=28) and type B or C fractures (group III, n=29). The anterolateral approach was performed in 50 patients with type A fractures (group II, n=32) and type B or C fractures (group IV, n=18). There were no significant differences between group I and group II nor between group III and group IV with respect to patient demographic data, surgical data, Constant score, ROM, or Mayo Elbow Performance score. A significant difference in the total complication rate was observed between group I and II. Conclusions: The anterolateral approach showed an advantage over the posterior approach for treating simple humeral midshaft fractures. However, this advantage was not observed in treating comminuted fractures.

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Section: Bsupporting

confidence: 86%

Comparison of the Posterior and Anterolateral Surgical Approaches in the Treatment of Humeral Mid-Shaft Fractures: A Retrospective Study

Tian

Leng

et al. 2020

Med Sci Monit

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“…Injury radiographs were reviewed, and the AO/Orthopaedic Trauma Association classification was used to classify the types of fractures. 8 Using simple radiography performed during the follow-up period (6,12,24, and 52 weeks after surgery), "union" was defined as the absence of a fracture line or the presence of a bridging callus. Shoulder and elbow joint ranges of motion (ROM) were also assessed.…”

Section: Methodsmentioning

confidence: 99%

Clinical outcomes of dual 3.5-mm locking compression plate fixation for humeral shaft fractures: Comparison with single 4.5-mm locking compression plate fixation

Seo

Heo

Yang

et al. 2019

J Orthop Surg (Hong Kong)

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Background: Recently, several in vitro biomechanical studies that used dual small locking plate fixation for humeral shaft fractures have investigated. However, in vivo studies about dual plate fixation for humeral shaft fractures are limited. The purpose of our study was to report the outcomes of dual small plating for humeral shaft fractures in comparison with those of single large fragment plating. Methods: Sixty consecutive patients who underwent an open reduction internal fixation for humeral shaft fractures at our institution from September 2014 to December 2017 were included. Single 4.5-mm locking compression plate (LCP) fixation was used in the first 40 cases, and dual 3.5-mm LCP fixation was used in the final 20 consecutive cases. Data were collected to define patient characteristics, injury mechanism, clinical outcomes, time to surgery, operative time, estimated blood loss, and complications. Using simple radiography during the follow-up period (6, 12, 24, and 52 weeks after surgery), the shoulder and elbow joint ranges of motion (ROM) were also evaluated. Results: Demographic data, time to surgery, surgical time, and estimated blood loss had no significant differences between the two groups. No significant differences were observed in nonunion rate and union rate 3 months after surgery. However, two patients (5%) in the single 4.5-mm LCP fixation group showed metal failure and breakage. No significant differences were found in postoperative shoulder and elbow ROM. Three patients (7.5%) in the single plating group and one patient (5%) in the dual plating group developed radial nerve palsy after surgery. No vascular injury and deep infection were observed in either group. Conclusion: For diaphyseal humeral fractures, dual 3.5-mm LCP fixation to the humerus is a possible treatment choice. This method showed satisfactory union rate, ROM, and complication rate, without increasing surgical time, in comparison with the conventional single 4.5-mm LCP fixation.

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“…3 Radial nerve dissection may be necessary in all surgical approaches to humerus due to close neighborhood of humerus and radial nerve. [20][21][22][23][24] Therefore, transient of permanent radial nerve injury may be seen. 25,26 We choose anterior approach in humerus shaft and distal diaphysis fractures, since it was possible to perform fixation without exposing the radial nerve.…”

Section: Discussionmentioning

confidence: 99%

Anterior humeral approach with nerve stimulator

Gülçek

Gamlı

2018

J Orthop Surg (Hong Kong)

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Introduction: The prevalence of radial nerve injury during surgery is as high as the prevalence of radial nerve injury due to trauma. The aim of this study is to minimize the risk of iatrogenic injury of radial nerve. Materials and Methods: Fifty patients with middle or distal diaphysis fractures of humerus and 18 patients with pseudoarthrosis at the same localizations were treated with surgery. Plate-screw fixation was performed with anterior approach in 43 patients. Eleven patients had minimally invasive plate osteosynthesis, and 14 patients had intramedullary nailing. The localization of the radial nerve was determined with nerve stimulator at the area of dissection. Results: Iatrogenic radial nerve injury did not occur in patients treated with open reduction or minimally invasive approach. Discussion: Nerve stimulator may be a method that decreases radial nerve injury, an iatrogenic complication. This method may be used in anterior approach and minimally invasive procedures.

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Surgical result of plate osteosynthesis using a locking plate system through an anterior humeral approach for distal shaft fracture of the humerus that occurred during a throwing motion

Abstract: The results of the current study indicates that plate osteosynthesis using a locking plate system combined with interfragmentary lag screws through anterior humeral approach may be a favorable option for the surgical treatment of humeral shaft fractures in throwers.

Cited by 15 publications

References 22 publications

Comparison of the Posterior and Anterolateral Surgical Approaches in the Treatment of Humeral Mid-Shaft Fractures: A Retrospective Study

Comparison of the Posterior and Anterolateral Surgical Approaches in the Treatment of Humeral Mid-Shaft Fractures: A Retrospective Study

Clinical outcomes of dual 3.5-mm locking compression plate fixation for humeral shaft fractures: Comparison with single 4.5-mm locking compression plate fixation

Anterior humeral approach with nerve stimulator

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