Surgical result of plate osteosynthesis using a locking plate system through an anterior humeral appraoch for distal shaft fracture of the humerus that occurred during throwing motion

Abstract

PURPOSE: This paper analyzed outcomes of the osteosynthesis with a locking plate system for the fractures of the humerus in throwers using the anterior humeral approach. METHODS: Retrospective case series including 31 patients. Bone union was assessed through follow-up radiographs. Results of visual analogue scale (VAS) for pain, range of motion in the elbow joint, time of return to work, and the Mayo Elbow Performance Score (MEPS) were evaluated to determine functional outcomes. Direction and length of the fracture, the distal cortical length, the humeral diameter, and the total humeral length were measured as part of fracture configuration analysis. RESULTS: Mean patient age was 25.8 (range, 18-34) years. The follow-up average was 16.0 months (range, 12-23). Delayed union was observed in one (3.1 %) patient. Mean final VAS was 0.4 (range, 0-2), mean time of return to work was 18.2 weeks (range, 13-36), and mean MEPS was 96.3 (range, 88-100) points. All fractures showed a spiral configuration. Mean fracture length was 79.7 (95 % CI, 72.6-86.7) mm, and mean distal cortical length was 48.3 (95 % CI, 37.8-58.8) mm. CONCLUSIONS: The results of the current study indicates that plate osteosynthesis using a locking plate system combined with interfragmentary lag screws through anterior humeral approach may be a favorable option for the surgical treatment of humeral shaft fractures in throwers.