Single versus double plate fixation of humeral shaft nonunion

被引:2
作者
Unal, Melih [1 ]
Kati, Yusuf Alper [1 ]
Acar, Baver [1 ]
Turan, Adil [1 ]
Ozturk, Serra [2 ]
Yuksel, Halil Yalcin [1 ]
机构
[1] Univ Hlth Sci, Med Fac, Antalya Training & Res Hosp, Dept Orthoped & Traumatol, Antalya, Turkiye
[2] Akdeniz Univ, Med Fac, Dept Anat, Antalya, Turkiye
关键词
Double plate; Fixation; Humeral shaft; Fractures; Nonunion; FRACTURES; MANAGEMENT; FAILURE;
D O I
10.1007/s00402-023-05111-6
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
IntroductionHumeral shaft fractures are common fractures of the diaphysis of the humerus. The aim of this study was to evaluate factors affecting the clinical outcomes of humeral nonunions surgically treated with open reduction and single- versus double-plate fixation with grafting.Materials and methodsA total of 31 patients with nonunion treated with single- or double-plate screw fixation with bone grafting were retrospectively analysed. The patients were divided into two groups according to the treatment method as Group 1 (single-plate, n = 14) and Group 2 (double-plate, n = 17). Data including demographic and clinical characteristics of the patients, initial and final treatment, type of nonunion and localisation, graft use, shortening, follow-up, time to union, Quick Disabilities of the Arm, Shoulder and Hand (Quick-DASH) scores, and patient-reported cosmetic outcomes were recorded.ResultsOf the patients, eight were males, and 23 were females, with a mean age of 47.6 +/- 15.8 (range, 20-86) years. Initial treatment was conservative treatment (Sarmiento brace) in seven patients, plate fixation in 22 patients, and intramedullary nailing in two patients. The mean follow-up was 31.0 +/- 16.9 months in Group 1 and 25.4 +/- 15.6 months in Group 2. There was one nonunion in Group 1 and three in Group 2. There were no significant differences in the union rate and time to union (p = 0.378 and p = 0.262, respectively). The mean Quick-DASH scores and cosmetic results were similar between the groups (p = 0.423 and p = 0.165, respectively). Radial nerve palsy developed in three patients in Group 2, and all these patients recovered completely during follow-up.ConclusionsAlthough the double-plate fixation technique has similar clinical, radiological, and functional results to single-plate fixation, it is a more invasive and expensive technique with a longer operation time. Therefore, it should not be used as the first-line treatment option for all humeral shaft nonunion. Nevertheless, the double-plate technique may be preferred to achieve in cases requiring high stability, such as hypertrophic nonunion, osteopenia and comminuted fractures.
引用
收藏
页码:693 / 699
页数:7
相关论文
共 50 条
[41]   Comparison of a multidimensional cross locking plate versus a locking compression plate for the treatment of femoral shaft nonunion: Finite element analysis [J].
Zhang, We ;
Hao, Ming ;
Chang, Zuhao ;
Wu, Yan ;
Tang, Peifu ;
Chen, Hua .
MEDICAL ENGINEERING & PHYSICS, 2020, 83 :106-111
[42]   Failure of humeral shaft fixation: construct characteristics [J].
Andrew D. Sobel ;
Kalpit N. Shah ;
Jeremy Raducha ;
Eva Koeller ;
Lina I. Ibrahim ;
Scott Paxton .
European Journal of Orthopaedic Surgery & Traumatology, 2023, 33 :3637-3641
[43]   Intramedullary Nail Versus Plate Fixation for Humeral Shaft Fractures: A Systematic Review of Overlapping Meta-analyses [J].
Zhao, Jia-Guo ;
Wang, Jia ;
Wang, Chen ;
Kan, Shi-Lian .
MEDICINE, 2015, 94 (11) :e599
[44]   Prospective comparative study between antegrade interlocking undreamed nail versus compression plate fixation of acute closed humeral mid third shaft humerus in adults [J].
Shukur, Ahmad Yaseen ;
Majeed, Ghadeer H. ;
Al-Edanni, Mohammed Sh. ;
Al-Muktar, Sadiq A. ;
Alany, Abdulkadr Muhammed Sleman ;
Dawood, Muthanna H. .
RAWAL MEDICAL JOURNAL, 2022, 47 (04) :911-916
[45]   Antegrade intramedullary nail versus plate fixation in the treatment of humeral shaft fractures An update meta-analysis [J].
Wen, Hongjie ;
Zhu, Shouyan ;
Li, Canzhang ;
Chen, Zhong ;
Yang, Huagang ;
Xu, Yongqing .
MEDICINE, 2019, 98 (46) :e17952
[46]   Open Reduction and Internal Fixation for Humeral Shaft Nonunion: Bone Grafting Is Not Routinely Required and Avoids Donor Site Morbidity [J].
Oliver, William M. ;
Molyneux, Samuel G. ;
White, Timothy O. ;
Clement, Nicholas D. ;
Duckworth, Andrew D. ;
Keating, John F. .
JOURNAL OF ORTHOPAEDIC TRAUMA, 2021, 35 (08) :414-423
[47]   Functional Outcomes in Aseptic Humeral Shaft Nonunion Treated With Plate Osteosynthesis: A Retrospective Cohort Study [J].
Mukhopadhaya, John ;
Bhadani, Janki Sharan ;
Ranjan, Rajeev ;
Kushwaha, Shubhanshu Ranjan .
INDIAN JOURNAL OF ORTHOPAEDICS, 2025, 59 (02) :218-230
[48]   Dual plating for fixation of humeral shaft fractures: A mechanical comparison of various combinations of plate lengths [J].
Karakasli, Ahmet ;
Basci, Onur ;
Ertem, Fatih ;
Sekik, Eyad ;
Havitcioglu, Hasan .
ACTA ORTHOPAEDICA ET TRAUMATOLOGICA TURCICA, 2016, 50 (04) :432-436
[49]   Locking compression plate fixation in humeral shaft fractures: A comparative study to literature conservative treatment [J].
Capitani, P. ;
Chiodini, F. ;
Di Mento, L. ;
Cavanna, M. ;
Bove, F. ;
Capitani, D. ;
Berlusconi, M. .
INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED, 2023, 54 :S2-S8
[50]   Schuhli augmentation of plate and screw fixation for humeral shaft fractures: A laboratory study [J].
Simon, JA ;
Dennis, MG ;
Kummer, FJ ;
Koval, KJ .
JOURNAL OF ORTHOPAEDIC TRAUMA, 1999, 13 (03) :196-199