Results of plate fixation for humerus fractures in a large single-center cohort
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ORTHOPAEDIC SURGERY
Results of plate fixation for humerus fractures in a large single‑center cohort B. J. M. van de Wall1,2 · C. Ganzert1 · C. Theus1 · R. J. H. van Leeuwen1 · B. C. Link1 · R. Babst1 · Frank J. P. Beeres1 Received: 17 June 2019 © Springer-Verlag GmbH Germany, part of Springer Nature 2019
Abstract Introduction This study aims to describe the results of plate fixation in one of the largest single-center cohorts that employs plate fixation as the golden standard. Additionally, risk factors related to a negative outcome were identified. Materials and methods This was a retrospective cohort study of all patients treated for a humeral shaft fracture in a level-one trauma center between January 2010 and December 2017 with a mean follow-up of 1 year. Results Plate fixation was performed in 102 patients with a humeral shaft fracture. The mean age was 50 (SD 20) years with 54.9% (n = 56) being male. Forty-eight percent (n = 48) had an AO type-A, 34.3% (n = 35) type-B, and 18.7% (n = 19) type-C fracture. Deep surgical site infections and non-union occurred in 1% (n = 1) and 3.9% (n = 4) of patients, respectively. Revision of the implant was performed in 15.7% (n = 16) mainly due to implant-related complaints. Only one patient developed radial nerve palsy after surgery. The median duration to radiological fracture healing and full-weight bearing was 18 (range 7–65) weeks and 14 (range 6–56) weeks, respectively. Risk factors for negative outcome included higher age, osteoporosis, open and higher AO class fractures, performing surgery during out-office hours, and the use of LCP 3.5-mm plate and an anterolateral approach. Conclusion Plate fixation for humeral shaft fractures has low risks of complications. It should be emphasized that the complications can be further minimized with a greater surgical expertise and by refraining from performing a surgery during out-office hours. Keywords Plate fixation · Humerus shaft fracture
Introduction Humeral shaft fractures represent 1–3% of all the fractures [1]. Classically, these fractures have been treated conservatively. Morbidity and related complications, as well as lower public tolerance of residual deformities and complaints of restricted motion of the adjacent joints, have led to indicate surgical treatment more liberally [1].
B. J. M. van de Wall and C. Ganzert contributed equally. * Frank J. P. Beeres [email protected] 1
Department of Trauma and Orthopedics, Luzerner Kantonsspital, Spitalstrasse 16, 6000 Luzern, Switzerland
Department of Traumatology, University Medical Center Utrecht, Heidelberglaan 100, 3584CX Utrecht, The Netherlands
2
Both the plate fixation and nailing techniques are being used. Plate fixation has been shown to decrease the rates of mal-union and non-union [2, 3]. The primary disadvantage of plate fixation is soft tissue disruption and with it higher chances if infection and radial nerve damage. Benefits of nailing include preservation of fracture biology, potentially faster time to union, decreased blood loss, and decr
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