[Plate osteosynthesis management of humerus shaft fractures]

During the period from 1 May 1990 to 30 November 1994, a total of 62 humeral shaft fractures were treated in the Department of Traumatology of the University of Bonn. In 42 instances the fracture was internally stabilized primarily, while in 13 instances the humeral shaft fractures were treated according to a regimen including primary stabilization, usually in an external fixateur, soft tissue reconstruction and delayed open reduction and internal fixation using an AO plate. The delayed stabilization was carried out 9.1 days, on average, after the injury. Seven pseudarthroses were treated electively. The indication for surgery was in 28 cases the associated injuries, 18 times the fracture type or form, 7 times a primary neurological deficit, 7 times a pseudarthrosis and twice the underlying systemic disease. A majority of the patients were involved in a motor vehicle accident. An open fracture was seen 6 times. Of the 19 primary radial palsies, 79% were associated with fractures of the distal diaphysis. The complication rate of 11% is comparable to that reported following intramedullary stabilization. No infection, pseudarthrosis or long-term radial palsy was observed. In three instances, twice following the revision of a pseudarthrosis, a temporary radial palsy was noted. All these neurological deficits resolved by the 6th postoperative day. Bony union was achieved after 16.2 weeks. If the surgeon adheres to the proper indications for open reduction and internal fixation, the compression plating of the humeral shaft fracture is a viable alternative to other forms of stabilization.