A comparative study of functional outcome in treatment of diaphyseal humerus fractures with open reduction and internal fixation by two different approaches, anterolateral and posterior

Abstract

Introduction: The humerus diaphyseal fractures account for 3% all bone fractures. Humerus diaphyseal fractures occurs in young adults because of high velocity injuries like road traffic accidents, fall from height, assaults and heavy machinery injuries, humerus diaphyseal fractures occurs in old age patients because of simple falls due to osteoporotic bones. Methods: A retrospective review was conducted of patients with humerus diaphyseal fractures. In all 26 patients were enrolled in the study, of which 13(50%) were treated with anterolateral approaches and the 13(50%) with posterior approaches. In this study we treated diaphyseal humerus fractures with open reduction and internal fixation by two different approaches, anterolateral and posterior, and compared results and functional outcome. Results: Out of all the 26 patients with diaphyseal humerus fracture 13 patients were operated with open reduction and internal fixation by plate osteosynthesis by anterolateral approach 10(38.46%) patients had excellent result, 1(3.84%) patient had good result and 3(11.53%) patients had poor result. And Out of all the 26 patients with diaphyseal humerus fracture 13 patients operated with posterior approach 9(34.61%) patients had excellent result, 4(15.38%) patients had good result and none had poor result. Conclusion: in our study we conclude that both approaches are equally effective for diaphyseal humerus fractures treatment in terms of fracture union, functional outcome and complications. Posterior approach to shaft humerus fracture is beneficial because with mobilization of radial nerve 76% of humerus shaft is exposed. In preoperative radial nerve palsy with diaphyseal shaft fractures posterior approach is better choice for nerve exploration. And anterolateral approach is better option for upper third and middle third diaphyseal humerus fractures and posterior approach is better option for distal third diaphyseal humerus fractures.