ASSESSMENT OF THE TREATMENT EFFICACY OF LOCKING COMPRESSION PLATES IN HUMERUS SHAFT FRACTURES

Introduction : In this study, we evaluated the efficacy of osteosynthesis by using locking plate in the treatment of humerus shaft fractures. Material and Methods : The mean age of 30 patients (19 male, 11 female) operated for humerus shaft fractures was 36.2 (23-66) years. A 3.5 locking compression plate was applied to all patients. We found radial nerve damage in 4 patients preoperatively. These lesions were considered neuropraxia and a dynamic splint was applied in order to keep wrist and fingers in extension after operation. Functional evaluation based on Stewart-Hundley criteria. The mean follow up period was 32 months (12-60 months). Results : Except 1 patient, all patients showed radiological healing in 14 weeks on average (10 week-24 week). Two patients showed union retardation, and the mean union time of these patients was 21 weeks. These were class C1 fractures with larger soft tissue damage and multifragments. One patient developed pseudoarthrosis. Besides primary surgery, this patient underwent a pseudoarthrosis surgery with plate-screw and iliac grafting. Radiological union was achieved at the 18th week. Four patients with preoperative radial nerve damage underwent early radial nerve exploration and plate-screw fixation. Then, dynamic wrist splint was applied. All of them healed in 4 months. Based on Stewart-Hundley criteria, the result was good in 27 (90%) cases, moderate in 2 (6.6%) patients, and bad in 1 (3.3%) patient. Radial nerve damage due to surgery occurred in 1 patient who achieved full recovery 3 months after surgery. A superficial skin infection was developed in 1 patient and it was managed with oral antibiotic therapy. None of the patients developed deep soft tissue infection which requires removal of the implant. Conclusion : In the treatment of humerus shaft fractures, osteosynthesis with locking plate may result in satisfactory radiologic and functional outcomes providing sufficient fixation and early mobilization when used with correct technique in adequate patient.