Dynamic Fixation of Humeral Shaft Fractures Using Active Locking Plates: A Prospective Observational Study

Area of Science:

• Orthopedic surgery
• Biomaterials science
• Trauma care

Background:

• Rigid plating inhibits fracture healing by limiting essential interfragmentary motion.
• Dynamic fixation with active locking plates allows controlled motion, promoting faster and stronger bone healing.
• This study details the first clinical application of active locking plates for humeral shaft fractures.

Purpose of the Study:

• To evaluate the durability and potential complications of active locking plates in stabilizing humeral shaft fractures.
• To assess the clinical efficacy of dynamic fixation in promoting bone healing and functional recovery.

Main Methods:

• Prospective observational study of eleven patients with AO/OTA types 12 A-C humeral shaft fractures.
• Fractures stabilized using active locking plates, allowing up to 1.5 mm of controlled interfragmentary motion.
• Radiographic assessment of healing and implant integrity, alongside patient-reported functional outcome measures.

Main Results:

• All active locking plates demonstrated durability without fatigue or failure over a 6-month period.
• Ten of eleven fractures achieved healing within 10.9 ± 5.2 weeks, with excellent functional outcomes (DASH, Constant, SF-12 scores).
• One case required revision surgery due to delayed union and fixation failure at the screw-bone interface.

Conclusions:

• Active locking plates provide safe and effective dynamic fixation for humeral shaft fractures.
• Dynamic fixation may enhance fracture healing and functional recovery compared to standard locked plating.
• Early clinical experience suggests promising results for active plates in orthopedic trauma management.