Metaphyseal Locking Compression Plate: A Reliable Solution for Distal Third Humerus Shaft Fractures Using a Posterior Approach for Appropriate Fracture Patterns

Author(s): Ashvin Mall, Sanjay Singh Rawat, Sneha Sharma, Arvind Aggarwal, Pulkesh Singh, Udit Kumar Jayant

Background: Distal humerus fractures present significant challenges due to the low mineral density of metaphyseal bone, complex periarticular anatomy, and small distal fragment size, complicating stable fixation. This study aims to evaluate the effectiveness of the posterior approach with a metaphyseal locking compression plate (LCP) to address these challenges and improve fracture management outcomes.

Materials and Methods: This prospective single-center study evaluated the functional and radiological outcomes of metaphyseal LCP fixation using the posterior approach for extra-articular fractures of the distal third humeral shaft. Follow-ups evaluated range of motion, activity levels, fracture union, implant stability, and complications. The Mayo Elbow Performance Score MEPS and VAS Visual Analogue Scale measured functional outcomes.

Results: The study included 28 patients. The radiological union was achieved in all, with a mean union time of 13.28 weeks. At the final followup, the mean elbow range of motion (ROM) was 125.7°, with 12 patients exhibiting minimal elbow flexion contractures ranging from 5° to 15°. The mean MEPS score at six months was 85.9 (range 70-95). No non-union, malunion, implant failure, or deep infection were observed. Two patients had transient radial nerve palsy, which resolved within three months postsurgery.

Conclusions: Utilising a metaphyseal locking compression plate (LCP) with a posterior approach is both an effective and safe method for treating extra-articular fractures of the distal third humeral shaft. This technique provides stable fixation, enabling early mobilisation and achieving excellent functional outcomes.