Functional Outcomes and Radiological Union of Midshaft Humeral Fractures Treated With Medial Plating Through an...

Background Humeral shaft fractures are common long-bone injuries that can be managed either conservatively or surgically, depending on fracture characteristics and patient-related factors. Medial plating through an anterolateral approach is an alternative surgical technique for fixation of mid-third humeral shaft fractures. This study aimed to evaluate functional outcomes and fracture healing following medial plating through an anterolateral approach for acute mid-third humeral shaft fractures, including radiological union, postoperative complications, and the association between injury-to-surgery interval and radiological union time. Methodology A prospective observational study was conducted in the Department of Orthopedics between March 2025 and September 2025. Forty-eight patients with acute mid-third humeral shaft fractures underwent open reduction and internal fixation using medial plate osteosynthesis through an anterolateral approach. Patients were followed for a minimum period of six months and a maximum of one year. Functional outcome assessment using the Rodríguez-Merchán criteria was performed at the final study assessment (six months). Radiological union, time to union, postoperative complications, and the association between time to surgery and union time were evaluated. Results The mean age of the study population was 47.0 ± 17.7 years. Road traffic accidents accounted for 32 (66.7%) of injuries, and males comprised 28 (58.3%) of the study population. At the final follow-up, excellent and good functional outcomes were achieved in 18 (37.5%) and 22 (45.8%) patients, respectively, resulting in an overall satisfactory outcome rate of 40 (83.3%). All fractures achieved radiological union, with a mean radiological union time of 14.9 ± 4.9 weeks. Delayed union occurred in four patients (8.3%). Postoperative complications included superficial surgical site infection in three patients (6.3%), radial nerve palsy in two patients (4.2%), and implant failure in one patient (2.1%). A statistically significant positive correlation was observed between the interval from injury to surgery and radiological union time (Pearson's r = 0.565, P < 0.001). Conclusions Medial plating through an anterolateral approach was associated with satisfactory functional outcomes, a high fracture union rate, and a low complication rate in patients with acute mid-third humeral shaft fractures. A longer interval from injury to surgery was associated with a longer radiological union time.