COMPRESSION PLATING OF HUMERAL SHAFT FRAC TURES

During the period from I May 1990 to 30 November 1994, a total of 62 h umeral shaft fractures were treated in the Department of Traumatology of the University of Bonn. In 42 instances the fracture was internally stabilized primarily, while in 13 instances the humeral shaft fractur es were treated according to a regimen including primary stabilization , usually in an external fixateur, soft tissue reconstruction and dela yed open reduction and internal fixation using an AO plate. The delaye d stabilization was carried out 9.1 days, on average, after the injury . Seven pseudarthroses were treated electively. The indication for sur gery was in 28 cases the associated injuries, 18 times the fracture ty pe or form, 7 times a primary neurological deficit, 7 times a pseudart hrosis and twice the underlying systemic disease. A majority of the pa tients were involved in a motor vehicle accident. An open fracture was seen 6 times. Of the 19 primary radial palsies, 79% were associated w ith fractures of the distal diaphysis. The complication rate of 11% is comparable to that reported following intramedullary stabilization. N o infection, pseudarthrosis or long-term radial palsy was observed. In three instances, twice following the revision of a pseudarthrosis, a temporary radial palsy was noted. All these neurological deficits reso lved by the 6th postoperative day. Bony union was achieved after 16.2 weeks. If the surgeon adheres to the proper indications for open reduc tion and internal fixation, the compression plating of the humeral sha ft fracture is a viable alternative to other forms of stabilization.