RESEARCH ARTICLE


Minimally Invasive Helical Plating for Shaft of Humerus Fractures: Technique and Outcome



James Chung Hui Tan*, 1, 2, Fareed Husain Yusuf Kagda 2, 3, Diarmuid Murphy2, Joseph S Thambiah2, Kok Sun Khong2
1 Khoo Teck Puat Hospital, Singapore
2 National University Hospital, Singapore
3 Jurong General Hospital, Singapore


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© Tan et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Khoo Teck Puat Hospital, 90 Yishun Central, 768828, Singapore; Tel: 65-66022187; Fax : 65-66023648; E-mail: sokajames@gmail.com


Abstract

Introduction:

The humerus is subjected to substantial amount of torsional stress. Conventional plating may not address this sufficiently and may lead to fixation failure or non-union. A helical plate may offer the solution. We present the surgical technique and functional outcome of 5 cases of humeral shaft fractures treated with this technique in a minimally invasive way.

Materials and Methods:

The operations were performed between 2004 and 2010, by three surgeons. All the patients had closed humeral shaft fractures, either simple transverse or with mild comminution. Two small incisions were made. The proximal incision was placed along the deltopectoral groove over the shaft, and the distal incision was placed as in an antero-lateral approach. The radial nerve was identified and protected. A pre-selected plate was contoured and introduced in the submuscular plane. The plate was placed in a proximal-lateral and distal-anterior position. Screws were inserted through stab incisions. The patients were followed for an average of 6 months. Functional recovery of the shoulder and elbow was assessed using the Constant and Mayo elbow performance score systems.

Results:

All incisions healed by first intention without complications and all the fractures went on to unite. All patients achieved good to excellent shoulder and elbow function.

Conclusion:

The helical plate technique is a safe and effective method of treating humeral shaft fractures and has good functional outcome.

Keywords: Shaft of humerus fracture, minimally invasive plating, helical plate.