Proximal to middle one-third humerus shaft fractures may lead to poorer shoulder function compared to middle to distal one-third humerus shaft fractures following internal fixation
Version of Record online: 5 JAN 2011
© 2011 British Elbow and Shoulder Society. Shoulder and Elbow © 2011 British Elbow and Shoulder Society
Shoulder & Elbow
Volume 3, Issue 1, pages 22–27, January 2011
How to Cite
Bormann, K. T., Carlson, M. J., Daccarett, M. S., Mormino, M. A. and Fehringer, E. V. (2011), Proximal to middle one-third humerus shaft fractures may lead to poorer shoulder function compared to middle to distal one-third humerus shaft fractures following internal fixation. Shoulder & Elbow, 3: 22–27. doi: 10.1111/j.1758-5740.2010.00100.x
- Issue online: 5 JAN 2011
- Version of Record online: 5 JAN 2011
- Received 16 March 2010; accepted 22 October 2010
Background The radiographic and functional outcomes following an anterior approach for plate fixation of humeral shaft fractures were evaluated and compared with those of a group having undergone plate fixation from a posterior approach. The hypothesis was that there would be no significant difference between these two groups in shoulder, elbow and overall upper extremity function.
Methods We retrospectively reviewed radiographs and data for 78 humerus shaft fractures. Twenty-six patients returned to complete the Constant–Murley Score (CMS), Simple Shoulder Test (SST), Mayo Elbow Performance Score (MEPS) and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire.
Results The overall median CMS [76.5 (A) versus 83.5 (P)] approached a significant difference between anterior and posterior fixation groups (p = 0.07). Active shoulder elevation was significantly better (p = 0.03) in the posterior group. There was no significant difference in median DASH score (p = 0.51), MEPS score (p = 0.69), nor in 10 of 12 individual responses on the SST. Fracture union rate was 97%.
Discussion Anterior fixation of humeral shaft fractures yields satisfactory upper extremity functional outcomes that are comparable to those of extremities that have undergone posterior fixation. However, shoulder function tends to be better following posterior fixation, possibly as a result of anterior approaches being more commonly performed for more proximal shaft fractures.