SURGICAL-TREATMENT OF HUMERAL SHAFT FRACTURES - THE BASEL EXPERIENCE

One hundred twenty seven patients with fractures of the humeral shaft were treated by open reduction and internal fixation using 4.5-mm dyna mic compression plates (DCP). Seventy one osteosyntheses were performe d primarily, 36 following attempted closed reduction, and 20 secondari ly after a failed conservative treatment of about 8 weeks. A primary r adial nerve palsy was present in 19 patients, and appeared subsequentl y in four additional patients. One hundred two of the 127 patients cou ld be clinically and radiologically examined 1 year after internal fix ation: 89 patients (87.3%) had excellent or good results with full fun ctional recovery. Thirteen patients (12.7%) showed a limited range of motion of either the shoulder or elbow or both. This was mostly becaus e of other fractures of the same limb or persistent neurologic impairm ent. We observed two transitory postoperative nerve palsies, five earl y failures of internal fixation because of technical errors, two pseud arthroses and four postoperative infections, which healed with one exc eption by suction drainage and early removal of the plate. We conclude that a correct plate fixation of humeral shaft fractures in a selecte d group of patients represents an alternative to conservative treatmen t with the advantage of greater patient comfort.