Treatment of the Fractures or Nonunions of Distal Shaft of the Humerus Using a Posterolateral Approach

Journal of the Korean Society for Surgery of the Hand 2007;12(4):212-217.
Published online December 1, 2007.

Jae Sung Lee, Min Jong Park, Hong Je Kang

후외측 접근법을 이용한 상완골 원위 간부의 골절 및 불유합의 치료

이재성, 박민종, 강홍제

Abstract

Purpose
To evaluate the efficacy of posterolateral approach in conjunction with posterior plating in surgical treatment for the fractures or nonunions of distal shaft of the humerus. Materials and Methods: Fifteen patients (mean age, 40 years) with a fracture or nonunion of the distal shaft of the humerus were treated with open reduction using a posterolateral approach and posterior plating. Nine patients had acute fractures and six had nonunions. They were followed up for a minimum of one year (range, 12~60 months). The time for union, Mayo elbow performance score and postoperative complications such as radial nerve palsy, implantation failure were assessed. Results: The average union time was 8.7 weeks in acute fractures, 12.6 weeks in nonunions. One patient with a nonunion failed to heal due to insufficient fixation and required reoperation. Transient radial nerve palsy after operation were observed in two patients and recovered by 4 months. According to the Mayo elbow performance score, the functional results were rated as exellent in 13 patients and good in two patients. Conclusion: Fractures or nonunions of the distal shaft of the humerus can be treated successfully using a posterolateral approach and posterior plating. This method exposes the entire fracture site easily, allows wide dissection of the radial nerve to prevent the nerve from iatrogenic injury and enable rigid distal fixation by extending a plate sufficiently to the posterior distal aspect of the humerus.