A simple technique for double plating of extraarticular distal humeral shaft fractures

Plate fixation of extraarticular distal humeral shaft fracture is often difficult. Traditional techniques do not allow for stable fixation. A single DCP plate may have inadequate purchase in the distal fragment. The use of large plates extending distally over the lateral supracondylar ridge is often associated with pain and sometimes interferes with elbow range of motion. In this study, 22 patients with extra articular distal humeral fractures were managed with dual plating using a paratricipital approach. The first plate - a narrow DCP - was fixed on the dorsal surface of the humerus. The second plate - a small 3.5 reconstruction plate - was fixed on the dorsolateral surface. Elbow motion was started immediately after surgery. The average follow-up duration was 25 months. The mean elbow flexion/extension arc was 4 degrees to 138 degrees. Infection was reported in two cases and was managed successfully with conservative measures. Postoperative radial nerve contusion was reported in one case with complete resolution within 3 months.