Outcome of Humeral Shaft Fracture Treated with Anteromedial Plating through an Anterolateral Approach

Abstract

Introduction: Humerus shaft fracture is a common injury representing 1.2-3% of
all fractures. It can be managed both conservatively and operatively with various
modalities. Among operative, plate osteosynthesis is the most widely accepted
method of treatment when conservative treatment is not adequate to achieve
union with good functional outcome. Anteromedial plating through anterolateral
approach is a safe and reliable approach in plate osteosynthesis.
Methods: A prospective study was conducted in the Department of orthopaedics,
Nepal APF hospital, Kathmandu from 2015 February to 2020 February. Fortyfour patients who underwent anteromedial plating for humeral shaft fracture
were included in the study. Patients were evaluated for functional recovery and
progress of fracture healing. Rodrigeuz-Merchan criteria was used to grade the
functional outcome.
Results: A total of 44 patients were included in the study with mean age of
36. There were 31 males and 13 females. The majority of patients 31 (70.45%)
sustained injury due to road traffic accident followed by fall from height 11 (25%)
and direct injury 2(4.55%). The most common fracture pattern was AO /OTA
Type A. The mean duration of surgery was 60±15min. Fracture union occurred in
less than 4 months in 36 patients (81.81%). Rodriguez Merchan criteria showed
majority of the patients had excellent 23(52.27%) and good 15 (34.1%) functional
outcomes.
Conclusion: Anteromedial plating provides a safe form of fixation of humeral
shaft fracture. It has benefit of supine positioning of the patient during operation
with good union rate, less fixation time, lesser complications leading to better
functional outcome.