Minimally invasive helical plating for shaft of humerus fractures: technique and outcome.
BACKGROUND
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.


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.


CONCLUSIONS
The helical plate technique is a safe and effective method of treating humeral shaft fractures and has good functional outcome.
Khoo Teck Puat Hospital, Singapore.
James Chung Hui
JC
Tan
Fareed Husain Yusuf
FH
Kagda
Diarmuid
D
Murphy
Joseph S
JS
Thambiah
Kok Sun
KS
Khong