Comparative Outcomes of Anterior and Posterior Plating for Distal-Third Humerus Shaft Fractures

Yuya Shimamoto; Katsuhiro Tokutake; Yasuhiko Takegami; Yuta Asami; Ken Sato; Hiroki Ueno; Takahiko Nakano; Sei Fujii; Nobuyuki Okui; Shiro Imagama

doi:10.1016/j.jhsa.2023.07.014

Comparative Outcomes of Anterior and Posterior Plating for Distal-Third Humerus Shaft Fractures

J Hand Surg Am. 2023 Sep 7:S0363-5023(23)00389-1. doi: 10.1016/j.jhsa.2023.07.014. Online ahead of print.

Authors

Affiliations

¹ Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
² Department of Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan. Electronic address: k.tokutake@med.nagoya-u.ac.jp.
³ Department of Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
⁴ Department of Orthopaedic Surgery, Yokkaichi Municipal Hospital, Yokkaichi, Japan.

PMID: 37676188
DOI: 10.1016/j.jhsa.2023.07.014

Abstract

Purpose: When treating distal-third humerus shaft fractures (HSFs) surgically, the optimal approach for plating is controversial. We conducted a retrospective multicenter study to investigate and compare the clinical outcomes of anterior and posterior plating in distal-third HSFs and the incidence of complications including iatrogenic radial nerve palsy.

Methods: We identified 116 patients from our multicenter trauma database who were diagnosed as having distal-third HSFs and who underwent surgical treatment, including intramedullary nailing between 2011 and 2020. We analyzed 50 cases treated in one of two ways: open reduction internal fixation with anterior plating (group A: 20 cases) and open reduction internal fixation with posterior plating (group P: 30 cases).

Results: The findings were similar in terms of operation time, estimated bleeding, and clinical and radiographic outcomes between the groups. Postoperative radial nerve palsy occurred only in group P (4 cases) and never in group A.

Conclusions: The results of this study suggest that the anterior approach is a safe and effective method for treating distal-third HSFs with satisfactory outcomes.

Type of study/level of evidence: Therapeutic IV.

Keywords: Anterior plating; distal-third humerus shaft fractures; posterior plating; radial nerve palsy.