Lee Jun-Ku, Choi Yun-Sung, Sim Young-Suk, Choi Dae-Sung, Han Soo-Hong
Orthopaedic Surgery, CHA Bundang Medical center, CHA University, Pocheon-si, Gyeonggi-do, Republic of Korea.
Int Orthop. 2017 Aug;41(8):1655-1661. doi: 10.1007/s00264-016-3355-4. Epub 2016 Dec 1.
Displaced unstable distal third fractures of the humeral diaphysis are treated surgically through open reduction and internal fixation. Conventionally, surgeons prefer using long plates for secure fixation; however, we performed short plate dual plating for robust fixation that required a smaller incision and less dissection through an anterior approach. In this study, we report the results of dual plating of fractures of the humeral shaft, with radiographic evidence and clinical analysis.
This retrospective study included 29 patients with distal third diaphyseal fractures of the humerus. There were 18 men and 11 women, with an average age of 43 years, and a mean follow-up period of 21.2 months. We investigated the type of fracture, plate length, number of fixed screws, and fracture union. Range of motion, Disabilities of Arm, Shoulder, and Hand (DASH) score, and complications during follow-up were analyzed for clinical results.
All fractures were classified according to AO classification. We used 4.5-mm narrow locking compression plates (LCP) and 3.5-mm LCP reconstruction plates. Fracture union was achieved in all cases during the follow-up. All patients recovered favourable elbow range of motion at final follow-up. At the final follow-up, average DASH score was 10.0, and no patient showed postoperative complications.
Satisfactory radiographic evidence and clinical results suggest that dual plating for distal diaphyseal humeral fractures may be considered a surgical option, with the advantages of strong fixation, less invasion of soft tissue, and early rehabilitation.
肱骨干远端三分之一移位不稳定骨折需通过切开复位内固定进行手术治疗。传统上，外科医生倾向于使用长钢板进行牢固固定；然而，我们采用短钢板双钢板固定术，通过前入路实现牢固固定，所需切口更小且解剖范围更小。在本研究中，我们报告肱骨干骨折双钢板固定的结果，并提供影像学证据和临床分析。
这项回顾性研究纳入了29例肱骨干远端三分之一骨折患者。其中男性18例，女性11例，平均年龄43岁，平均随访期为21.2个月。我们调查了骨折类型、钢板长度、固定螺钉数量和骨折愈合情况。分析了随访期间的活动范围、上肢、肩部和手部功能障碍（DASH）评分以及并发症，以评估临床结果。
所有骨折均根据AO分类法进行分类。我们使用了4.5毫米窄锁定加压钢板（LCP）和3.5毫米LCP重建钢板。随访期间所有病例均实现骨折愈合。所有患者在末次随访时肘关节活动范围恢复良好。末次随访时，平均DASH评分为10.0，无患者出现术后并发症。
令人满意的影像学证据和临床结果表明，肱骨干远端骨折双钢板固定术可被视为一种手术选择，具有固定牢固、软组织侵袭少和早期康复的优点。
