Diaphyseal fractures of the humerus treated by open reduction and internal fixation

ABSTRACT

This paper presents our experience with 57 patients of diaphyseal fractures of the humerus, treated by open reduction and fixation with dynamic compression plate. The indications for surgical treatment included delayed union in 29 patients, soft tissue interposition in 11, multiple injuries in 8, and radial nerve involvement in 9. Seven patients among the 19 who had routine exploration of the radial nerve palsy, took 6 to 12 weeks to recover. We recommend that fractures which do not show evidence of union in 6-8 weeks are unlikely to unite and should be treated by open reduction and internal fixation. Fractures with a gap between the fragments either in anteroposterior or in lateral radiographs and fractures with distraction of the fragments commonly have soft tissue interposition and should have primary open reduction and internal fixation. Exploration of the radial nerve during primary fixation of the fracture should only be done in patients presenting with radial nerve involvement