Dual plate fixation on distal third diaphyseal fracture of the humerus

Displaced unstable distal third fractures of the humeral diaphysis are treated surgically through open reduction and internal fixation. Conventionally, surgeons prefer using long plates for secure fixation; however, we performed short plate dual plating for robust fixation that required a smaller incision and less dissection through an anterior approach. In this study, we report the results of dual plating of fractures of the humeral shaft, with radiographic evidence and clinical analysis.

This retrospective study included 29 patients with distal third diaphyseal fractures of the humerus. There were 18 men and 11 women, with an average age of 43 years, and a mean follow-up period of 21.2 months. We investigated the type of fracture, plate length, number of fixed screws, and fracture union. Range of motion, Disabilities of Arm, Shoulder, and Hand (DASH) score, and complications during follow-up were analyzed for clinical results.

All fractures were classified according to AO classification. We used 4.5-mm narrow locking compression plates (LCP) and 3.5-mm LCP reconstruction plates. Fracture union was achieved in all cases during the follow-up. All patients recovered favourable elbow range of motion at final follow-up. At the final follow-up, average DASH score was 10.0, and no patient showed postoperative complications.

Satisfactory radiographic evidence and clinical results suggest that dual plating for distal diaphyseal humeral fractures may be considered a surgical option, with the advantages of strong fixation, less invasion of soft tissue, and early rehabilitation.