Skip to main content
SpringerLink
Log in

Surgical result of plate osteosynthesis using a locking plate system through an anterior humeral approach for distal shaft fracture of the humerus that occurred during a throwing motion

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

Purpose

This paper analyzed outcomes of the osteosynthesis with a locking plate system for the fractures of the humerus in throwers using the anterior humeral approach.

Methods

Retrospective case series including 31 patients. Bone union was assessed through follow-up radiographs. Results of visual analogue scale (VAS) for pain, range of motion in the elbow joint, time of return to work, and the Mayo Elbow Performance Score (MEPS) were evaluated to determine functional outcomes. Direction and length of the fracture, the distal cortical length, the humeral diameter, and the total humeral length were measured as part of fracture configuration analysis.

Results

Mean patient age was 25.8 (range, 18–34) years. The follow-up average was 16.0 months (range, 12–23). Delayed union was observed in one (3.1 %) patient. Mean final VAS was 0.4 (range, 0–2), mean time of return to work was 18.2 weeks (range, 13–36), and mean MEPS was 96.3 (range, 88–100) points. All fractures showed a spiral configuration. Mean fracture length was 79.7 (95 % CI, 72.6-86.7) mm, and mean distal cortical length was 48.3 (95 % CI, 37.8-58.8) mm.

Conclusions

The results of the current study indicates that plate osteosynthesis using a locking plate system combined with interfragmentary lag screws through anterior humeral approach may be a favorable option for the surgical treatment of humeral shaft fractures in throwers.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Chao SL, Miller M, Teng SW (1971) A mechanism of spiral fracture of the humerus: a report of 129 cases following the throwing of hand grenades. J Trauma 11(7):602–605

    Article  CAS  PubMed  Google Scholar 

  2. Ogawa K, Yoshida A (1998) Throwing fracture of the humeral shaft. An analysis of 90 patients. Am J Sports Med 26(2):242–246

    CAS  PubMed  Google Scholar 

  3. Branch T, Partin C, Chamberland P, Emeterio E, Sabetelle M (1992) Spontaneous fractures of the humerus during pitching. A series of 12 cases. Am J Sports Med 20(4):468–470

    Article  CAS  PubMed  Google Scholar 

  4. Sakai K, Kiriyama Y, Kimura H, Nakamichi N, Nakamura T, Ikegami H, Matsumoto H, Toyama Y, Nagura T (2010) Computer simulation of humeral shaft fracture in throwing. J Shoulder Elbow Surg 19(1):86–90. doi:10.1016/j.jse.2009.05.006

    Article  PubMed  Google Scholar 

  5. Miller A, Dodson CC, Ilyas AM (2014) Thrower’s fracture of the humerus. Orthop Clin N Am 45(4):565–569. doi:10.1016/j.ocl.2014.06.011

    Article  Google Scholar 

  6. Lee CS, Davis SM, Ho HA, Fronek J (2013) Humeral shaft fracture treatment in the elite throwing athlete: a unique application of flexible intramedullary nailing. Case Rep Orthop 2013:546804. doi:10.1155/2013/546804

    PubMed  PubMed Central  Google Scholar 

  7. Bhandari M, Fong K, Sprague S, Williams D, Petrisor B (2012) Variability in the definition and perceived causes of delayed unions and nonunions: a cross-sectional, multinational survey of orthopaedic surgeons. J Bone Joint Surg Am 94(15):e1091–e1096. doi:10.2106/JBJS.K.01344

    Article  PubMed  Google Scholar 

  8. Morshed S, Corrales L, Genant H, Miclau T 3rd (2008) Outcome assessment in clinical trials of fracture-healing. J Bone Joint Surg Am 90(Suppl 1):62–67. doi:10.2106/JBJS.G.01556

    Article  PubMed  Google Scholar 

  9. Corrales LA, Morshed S, Bhandari M, Miclau T 3rd (2008) Variability in the assessment of fracture-healing in orthopaedic trauma studies. J Bone Joint Surg Am 90(9):1862–1868. doi:10.2106/JBJS.G.01580

    Article  PubMed  PubMed Central  Google Scholar 

  10. Morrey B, An K, Chao E (1993) Functional evaluation of the elbow. In: Morrey B (ed) The elbow and its disorders, vol 2nd. WB Saunders, Philadelphia, p 95

    Google Scholar 

  11. Cusick MC, Bonnaig NS, Azar FM, Mauck BM, Smith RA, Throckmorton TW (2014) Accuracy and reliability of the Mayo Elbow Performance Score. J Hand Surg [Am] 39(6):1146–1150. doi:10.1016/j.jhsa.2014.01.041

    Article  Google Scholar 

  12. Fleisig GS, Barrentine SW, Escamilla RF, Andrews JR (1996) Biomechanics of overhand throwing with implications for injuries. Sports Med 21(6):421–437

    Article  CAS  PubMed  Google Scholar 

  13. Sabick MB, Torry MR, Kim YK, Hawkins RJ (2004) Humeral torque in professional baseball pitchers. Am J Sports Med 32(4):892–898

    Article  PubMed  Google Scholar 

  14. Hershman EB, Mailly T (1990) Stress fractures. Clin Sports Med 9(1):183–214

    CAS  PubMed  Google Scholar 

  15. Warden SJ, Bogenschutz ED, Smith HD, Gutierrez AR (2009) Throwing induces substantial torsional adaptation within the midshaft humerus of male baseball players. Bone 45(5):931–941. doi:10.1016/j.bone.2009.07.075

    Article  PubMed  Google Scholar 

  16. McKee MD, Larsson S (2009) Humeral shaft fractures. In: Bucholz RW, Heckman JD, Court-Brown CM, Tornetta P (eds) Rockwood and Green’s Fractures in adults, vol 7. Lippincott Williams & Wilkins, Philadelphia, pp 1000–1017

    Google Scholar 

  17. Kinaci A, Kloen P, Videler A (2014) Kreulen M (2014) Unusual radial nerve injury by a locking compression plate for humerus fracture. BMJ Case Rep. doi:10.1136/bcr-2013-201515

    PubMed  PubMed Central  Google Scholar 

  18. Baker DM (1971) Fracture of the humeral shaft associated with ipsilateral fracture dislocation of the shoulder: report of a case. J Trauma 11(6):532–534

    Article  CAS  PubMed  Google Scholar 

  19. Schatzker J (1996) Fractures of the humerus. In: Schatzer J, Tile M (eds) The rationale for operative fracture care, vol 2. Springer, Berlin, pp 83–94

    Chapter  Google Scholar 

  20. Tingstad EM, Wolinsky PR, Shyr Y, Johnson KD (2000) Effect of immediate weightbearing on plated fractures of the humeral shaft. J Trauma 49(2):278–280

    Article  CAS  PubMed  Google Scholar 

  21. Vander Griend R, Tomasin J, Ward EF (1986) Open reduction and internal fixation of humeral shaft fractures. Results using AO plating techniques. J Bone Joint Surg Am 68(3):430–433

    CAS  PubMed  Google Scholar 

  22. Bell MJ, Beauchamp CG, Kellam JK, McMurtry RY (1985) The results of plating humeral shaft fractures in patients with multiple injuries. The Sunnybrook experience. J Bone Joint Surg (Br) 67(2):293–296

    CAS  Google Scholar 

  23. Apivatthakakul T, Arpornchayanon O, Bavornratanavech S (2005) Minimally invasive plate osteosynthesis (MIPO) of the humeral shaft fracture. Is it possible? A cadaveric study and preliminary report. Injury 36(4):530–538. doi:10.1016/j.injury.2004.05.036

    Article  CAS  PubMed  Google Scholar 

  24. Pickering RM, Crenshaw AH Jr, Zinar DM (2002) Intramedullary nailing of humeral shaft fractures. Instr Course Lect 51:271–278

    PubMed  Google Scholar 

Download references

Acknowledgments

Bong-Gun Lee received a grant (HY-2012-N) from Hanyang University.

Conflicts of Interest

None declared.

Author information

Authors and Affiliations

  1. Department of Orthopedic Surgery, College of Medicine, Hanyang University, 17 Haengdang-Dong, Sungdong-Gu, Seoul, Korea

    Sung-Jae Kim, Sang-Hyun Lee, Heejung Son & Bong-Gun Lee

Authors
  1. Sung-Jae Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sang-Hyun Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Heejung Son
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Bong-Gun Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Bong-Gun Lee.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kim, SJ., Lee, SH., Son, H. et al. Surgical result of plate osteosynthesis using a locking plate system through an anterior humeral approach for distal shaft fracture of the humerus that occurred during a throwing motion. International Orthopaedics (SICOT) 40, 1489–1494 (2016). https://doi.org/10.1007/s00264-015-2895-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-015-2895-3

Keywords

Search

Navigation