OSTEOSYNTHESIS OF HUMERAL SHAFT FRACTURES BY ORIF AND DCP

Within a period of 7 years 103 patients with fractures of the humeral shaft of type 1.2 A-C according to the AO-classification were treated operatively by open reduction and internal fixation by Dynamic Compres sion Plates (DCP). The main indication for primary osteosynthesis (n = 34) was the radial nerve palsy (n = 13), followed by pathological fra ctures (n = 9), open fractures and polytrauma (n = 8) and plexus and a rterial lesions (n = 4). The most common indication for secondary surg ery (n = 69) was non-union or failed conservative treatment (n = 19), followed by means of intensive care nursing (n = 12) and further 12 ca ses of radial palsy. Other patients were treated operatively because o f local or nearby bone, joint and soft-tissue problems but there are a lso general indications such as fast functional recovery or personal a ttributes. The functional results were excellent and good in 88.4 % of all patients. 11.6 % had poor and bad results caused by continued ner ve or plexus palsies and concomittant fractures on the same limb. The rate of postoperative radial palsies (all with full rehabilitation) wa s 2.9 %. In one case we saw a deep infection with osteitis. A non-unio n after osteosynthesis did not occur. Osteosynthesis with the DCP is a safe procedure in humeral shaft fractures with low complications in t he hands of the experienced trauma surgeon. Indications for the proced ure are differentiated against other procedures as conservative treatm ent, external fixator and the nailing techniques.