Clinical study on dual plating for delayed unions and nonunions of distal 1/3 and diaphyseal-metaphyseal transition of humerus

Tae-Hyok Ri; Hyung-Jun Jon; Dong-Ju Kim; In-Song Ri; Gwang-Nam Kang; Sang-Hun Ri; Jong-Pyong Hwang

Abstract

Background: The best treatment for delayed union and non-union at distal 1/3 and metaphyseal-diaphyseal transition of humerus is not well established. We collected retrospective and prospective outcomes data for patients undergoing open reduction and internal fixation for delayed union and non-union of distal 1/3 and metaphyseal-diaphyseal transition of humerus with use of conventional mono-lateral or dual plating. Methods and Material: Over a 2-year period, 35 patients underwent open reduction and internal fixation of delayed union and non-union of distal 1/3 and metaphyseal-diaphyseal transition of humerus with use of conventional mono-lateral (control group, 19 cases) or dual plating (study group, 16 cases). In the present study patients were enrolled 3 months after operation on the basis of strict entry criteria and were evaluated 3, 6, and 12 months after surgery. Outcome measures included incidence rate of complication, radiographic parameters, elbow range of motion, and Mayo Elbow Performance Index (MEPI). Statistical analysis used: Results: Thirty five patients with delayed union or non-union of distal metaphyseal-diaphyseal transition of humerus were enrolled. The mean age at the time of enrolment was 42.9 years. There were 21 delayed unions and 14 cases of non-unions. Fifty seven percent (eight) of the fourteen non-unions were classified as hypertrophic type and forty three percent (six) were classified as atrophic type. Radiographic assessment showed that the dual plating system maintained good reduction and alignment at the follow-up periods. At the time of the twelve-month follow-up, incidence rate of complication, radiographic parameters, elbow range of motion, and Mayo Elbow Performance Index (MEPI) showed statistically better results in study group compared to those in control group. Conclusions: The dual plating system appears to provide effective fixation when used for the treatment of delayed union or non-union of distal 1/3 and metaphyseal-diaphyseal transition of humerus. Keywords: Delayed union, dual plating, double plating, humerus, metaphyseal-diaphyseal transition, non-unionCite this ArticleTae-Hyok Ri, Hyung-Jun Jon, Dong-Ju Kim, In-Song Ri, Gwang-Nam Kang, Sang-Hun Ri, Jong-Pyong Hwang. Clinical Study on Dual Plating for Delayed Unions and Nonunions of Distal 1/3 and Diaphyseal-Metaphyseal Transition of Humerus. Research & Reviews: Journal of Surgery. 2020; 9(1): 10–15p.