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International Orthopaedics

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01-07-2016 | Original Paper

Surgical result of plate osteosynthesis using a locking plate system through an anterior humeral approach for distal shaft fracture of the humerus that occurred during a throwing motion

Authors: Sung-Jae Kim, Sang-Hyun Lee, Heejung Son, Bong-Gun Lee

Published in: International Orthopaedics | Issue 7/2016

Abstract

Purpose

This paper analyzed outcomes of the osteosynthesis with a locking plate system for the fractures of the humerus in throwers using the anterior humeral approach.

Methods

Retrospective case series including 31 patients. Bone union was assessed through follow-up radiographs. Results of visual analogue scale (VAS) for pain, range of motion in the elbow joint, time of return to work, and the Mayo Elbow Performance Score (MEPS) were evaluated to determine functional outcomes. Direction and length of the fracture, the distal cortical length, the humeral diameter, and the total humeral length were measured as part of fracture configuration analysis.

Results

Mean patient age was 25.8 (range, 18–34) years. The follow-up average was 16.0 months (range, 12–23). Delayed union was observed in one (3.1 %) patient. Mean final VAS was 0.4 (range, 0–2), mean time of return to work was 18.2 weeks (range, 13–36), and mean MEPS was 96.3 (range, 88–100) points. All fractures showed a spiral configuration. Mean fracture length was 79.7 (95 % CI, 72.6-86.7) mm, and mean distal cortical length was 48.3 (95 % CI, 37.8-58.8) mm.

Conclusions

The results of the current study indicates that plate osteosynthesis using a locking plate system combined with interfragmentary lag screws through anterior humeral approach may be a favorable option for the surgical treatment of humeral shaft fractures in throwers.

Chao SL, Miller M, Teng SW (1971) A mechanism of spiral fracture of the humerus: a report of 129 cases following the throwing of hand grenades. J Trauma 11(7):602–605CrossRefPubMed

Ogawa K, Yoshida A (1998) Throwing fracture of the humeral shaft. An analysis of 90 patients. Am J Sports Med 26(2):242–246PubMed

Branch T, Partin C, Chamberland P, Emeterio E, Sabetelle M (1992) Spontaneous fractures of the humerus during pitching. A series of 12 cases. Am J Sports Med 20(4):468–470CrossRefPubMed

Sakai K, Kiriyama Y, Kimura H, Nakamichi N, Nakamura T, Ikegami H, Matsumoto H, Toyama Y, Nagura T (2010) Computer simulation of humeral shaft fracture in throwing. J Shoulder Elbow Surg 19(1):86–90. doi:10.1016/j.jse.2009.05.006 CrossRefPubMed

Miller A, Dodson CC, Ilyas AM (2014) Thrower’s fracture of the humerus. Orthop Clin N Am 45(4):565–569. doi:10.1016/j.ocl.2014.06.011 CrossRef

Lee CS, Davis SM, Ho HA, Fronek J (2013) Humeral shaft fracture treatment in the elite throwing athlete: a unique application of flexible intramedullary nailing. Case Rep Orthop 2013:546804. doi:10.1155/2013/546804 PubMedPubMedCentral

Bhandari M, Fong K, Sprague S, Williams D, Petrisor B (2012) Variability in the definition and perceived causes of delayed unions and nonunions: a cross-sectional, multinational survey of orthopaedic surgeons. J Bone Joint Surg Am 94(15):e1091–e1096. doi:10.2106/JBJS.K.01344 CrossRefPubMed

Morshed S, Corrales L, Genant H, Miclau T 3rd (2008) Outcome assessment in clinical trials of fracture-healing. J Bone Joint Surg Am 90(Suppl 1):62–67. doi:10.2106/JBJS.G.01556 CrossRefPubMed

Corrales LA, Morshed S, Bhandari M, Miclau T 3rd (2008) Variability in the assessment of fracture-healing in orthopaedic trauma studies. J Bone Joint Surg Am 90(9):1862–1868. doi:10.2106/JBJS.G.01580 CrossRefPubMedPubMedCentral

10.

Morrey B, An K, Chao E (1993) Functional evaluation of the elbow. In: Morrey B (ed) The elbow and its disorders, vol 2nd. WB Saunders, Philadelphia, p 95

11.

Cusick MC, Bonnaig NS, Azar FM, Mauck BM, Smith RA, Throckmorton TW (2014) Accuracy and reliability of the Mayo Elbow Performance Score. J Hand Surg [Am] 39(6):1146–1150. doi:10.1016/j.jhsa.2014.01.041 CrossRef

12.

Fleisig GS, Barrentine SW, Escamilla RF, Andrews JR (1996) Biomechanics of overhand throwing with implications for injuries. Sports Med 21(6):421–437CrossRefPubMed

13.

Sabick MB, Torry MR, Kim YK, Hawkins RJ (2004) Humeral torque in professional baseball pitchers. Am J Sports Med 32(4):892–898CrossRefPubMed

14.

Hershman EB, Mailly T (1990) Stress fractures. Clin Sports Med 9(1):183–214PubMed

15.

Warden SJ, Bogenschutz ED, Smith HD, Gutierrez AR (2009) Throwing induces substantial torsional adaptation within the midshaft humerus of male baseball players. Bone 45(5):931–941. doi:10.1016/j.bone.2009.07.075 CrossRefPubMed

16.

McKee MD, Larsson S (2009) Humeral shaft fractures. In: Bucholz RW, Heckman JD, Court-Brown CM, Tornetta P (eds) Rockwood and Green’s Fractures in adults, vol 7. Lippincott Williams & Wilkins, Philadelphia, pp 1000–1017

17.

Kinaci A, Kloen P, Videler A (2014) Kreulen M (2014) Unusual radial nerve injury by a locking compression plate for humerus fracture. BMJ Case Rep. doi:10.1136/bcr-2013-201515 PubMedPubMedCentral

18.

Baker DM (1971) Fracture of the humeral shaft associated with ipsilateral fracture dislocation of the shoulder: report of a case. J Trauma 11(6):532–534CrossRefPubMed

19.

Schatzker J (1996) Fractures of the humerus. In: Schatzer J, Tile M (eds) The rationale for operative fracture care, vol 2. Springer, Berlin, pp 83–94CrossRef

20.

Tingstad EM, Wolinsky PR, Shyr Y, Johnson KD (2000) Effect of immediate weightbearing on plated fractures of the humeral shaft. J Trauma 49(2):278–280CrossRefPubMed

21.

Vander Griend R, Tomasin J, Ward EF (1986) Open reduction and internal fixation of humeral shaft fractures. Results using AO plating techniques. J Bone Joint Surg Am 68(3):430–433PubMed

22.

Bell MJ, Beauchamp CG, Kellam JK, McMurtry RY (1985) The results of plating humeral shaft fractures in patients with multiple injuries. The Sunnybrook experience. J Bone Joint Surg (Br) 67(2):293–296

23.

Apivatthakakul T, Arpornchayanon O, Bavornratanavech S (2005) Minimally invasive plate osteosynthesis (MIPO) of the humeral shaft fracture. Is it possible? A cadaveric study and preliminary report. Injury 36(4):530–538. doi:10.1016/j.injury.2004.05.036 CrossRefPubMed

24.

Pickering RM, Crenshaw AH Jr, Zinar DM (2002) Intramedullary nailing of humeral shaft fractures. Instr Course Lect 51:271–278PubMed

Title: Surgical result of plate osteosynthesis using a locking plate system through an anterior humeral approach for distal shaft fracture of the humerus that occurred during a throwing motion
Authors: Sung-Jae Kim
Sang-Hyun Lee
Heejung Son
Bong-Gun Lee
Publication date: 01-07-2016
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 7/2016
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-015-2895-3

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Surgical result of plate osteosynthesis using a locking plate system through an anterior humeral approach for distal shaft fracture of the humerus that occurred during a throwing motion

Abstract

Purpose

Methods

Results

Conclusions

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Abstract

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