The Use of Locking Small Fragment Plates for Treatment of Humeral Shaft Fractures

Description: Abstract OTA paper 2004
Conclusion/Significance: Plating of humeral shaft fractures has traditionally been performed with 4.5-mm dynamic compression plates, broad or narrow, with good results, and this method is treated as our control group in this study. The smaller 3.5-mm plate offers the theoretical advantage of more holes per unit length, especially useful in complex comminuted fractures or periarticular fractures, particularly of the distal third of the humeral shaft. They are generally more easily contoured and are more easily positioned on the humerus. Decreased need for dissection resulting in fewer traumas to the radial nerve may also be an advantage. The advent of locked-plating technology makes these implants even more attractive for routine use in fixation of the humeral shaft. In our series, no failures occurred in the locked-plating group, even with weight-bearing. Although the larger plates remain the likely implant of choice for nonunion of the humerus, we believe that these results support the use of 3.5-mm plates, particularly the locking-compression plates, for the routine operative treatment of humeral shaft fractures.