Surgical treatment of adult extra-articular distal humeral diaphyseal fractures using an oblique metaphyseal locking compression plate via a posterior approach

ABSTRACT

The purpose of this study was to evaluate the feasibility and clinical outcome of using an oblique AO [Association for the Study of Internal Fixation] metaphyseal locking compression plate [MLCP] in the treatment of adult extra-articular distal humeral diaphyseal fractures via a posterior approach. A series of 19 cases of adult extra-articular distal humeral diaphyseal fractures were surgically treated using an MLCP and lag screws, if necessary, via a posterior approach. All patients were followed for a mean time of 16.6 months [range from 12 to 20 months]. The patients were followed up to 1 year, and radiological assessment was performed to observe fracture reduction and healing. Functional outcome was measured including the range of motion of the shoulder and elbow, by the University of California at Los Angeles and the Mayo Elbow Performance Score. The incidence of iatrogenic radial nerve palsy was 5%. There was no failure of internal fixation and no infection. After 1 year, the University of California at Los Angeles scoring system rated 12 [63.2%] patients as excellent results. The Mayo elbow performance scoring system rated 10 [84%] cases as excellent results. Completely normal alignment was presented in 16 cases. Following surgical treatment of adult extra-articular distal humeral diaphyseal fractures, an oblique MLCP applied via a posterior approach achieved an adequate internal fixation and obtained an excellent functional outcome: