International Journal of Research in Orthopaedics | January-February 2020 | Vol 6 | Issue 1 Page 158
International Journal of Research in Orthopaedics
Kaki D et al. Int J Res Orthop. 2020 Jan;6(1):158-163
http://www.ijoro.org
Original Research Article
A prospective study on clinical outcome of humerus shaft fracture and
nonunion treated with antero medial plating
Deepak Kaki, T. Naveen Babu*, Sunil Malagan, Karthik Gudaru, Jagadesh Gudaru
INTRODUCTION
Humeral shaft fractures are relatively common fractures
presenting to trauma services, with an incidence of 13 per
100000 per year and account for 3% of total fractures.
1
The incidence shows bimodal distribution with peak
incidence for males between 20 to 30 years of age and a
second peak for older females aged between 60 and 70
years.
2,3
The rate of non-union reported following open
reduction and internal fixation or closed IM nailing is up
to 13%. Operative options include plate osteosynthesis
and intra medullary nailing. Both methods of fixation are
having their own pros and cons. Common benefit being
early mobilization, which may lead to earlier functional
recovery and reduced pain.
4,5
With benefits like early
mobilisation, rigid fixation, reduced complications and
opportunity to address problems like primary radial nerve
injuries there is a growing interest in treating humeral
shaft fractures by plate osteosynthesis.
6,7
Further the
debate on best approach for plate osteosynthesis shows
benefit and limitations of various approaches like
posterior, anterolateral, anterior and medial. By placing
the plate on the medial surface, excessive soft tissue
dissection for visualization and preservation of the radial
ABSTRACT
Background: Humeral shaft fractures have an incidence of 13 per 100000 per year and account for 3% of total
fractures. The following study is carried out with intention for determining and verifying facts around plate
osteosynthesis on anteromedial surface of humerus through anterior approach.
Methods: This is a prospective study of 38 patients presenting with humerus shaft fracture and non-union to the
Balaji Institute of Surgery Research and Rehabilitation for the Disabled (BIRRD) from April 2015 to March 2016.
Inclusion criteria were age>18 years, acute humerus shaft fractures and nonunion of humerus shaft. Exclusion criteria
were undisplaced fractures, fractures associated with neurovascular injury, compound and pathological fractures,
infected non unions. The functional outcome was graded based on the QuickDASH score. Fisher’s exact test was used
to find the association between categorical data.
Results: Clinical union was noted in 87% of the patients and radiological union in 74% at the end of three months.
The average time period required to achieve union was 13.57 weeks. Based on Quick DASH score, 66% of them had
excellent outcome, 24% had good outcome, 10% had fair outcome, and none had poor outcome.
Conclusions: It may be concluded that, anteromedial plating through anterior approach for the treatment of humerus
shaft fractures and non union leads to a satisfactory functional outcome in most of the patients. Most of the fractures
were united by 3 months with good range of motion of shoulder and elbow.
Keywords: Humerus shaft fracture, Anteromedial plating, Plate osteosynthesis
Department of Orthopaedics, BIRRD (T) Hospital, Tirupati, Andhra Pradesh, India
Received: 28 September 2019
Revised: 09 December 2019
Accepted: 11 December 2019
*Correspondence:
Dr. T. Naveen Babu,
E-mail: naveen782@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20195810