Adjunct fixation in upper extremity long bone fracture plating

A variety of adjunct fixation methods to supplement primary plate and screw constructs are available. There are no large clinical series of these techniques in the upper extremity. The purpose of this study was to review patients with upper extremity fractures that underwent primary plating with adjunct fixation.

This study was a retrospective review of plate fixation of humeral, radial and ulnar fractures over a 12-year period. Measurable outcomes for this study included rates of non-union, complications, and implant removal.

Thirty-nine humeral shaft fractures had supplemental fixation 97% of the time, with a 100% union rate. Supplemental fixation was used in 79% of forearm cases. There was a 98% initial union rate in 48 acutely plated forearm fractures.

Although a variety of techniques were employed, the mini-fragment (2.7 mm or smaller) was the most common strategy for adjunctive fixation of long bone fractures in the upper extremity.