Mid-term outcome of minimally invasive anterior bridge plating versus conventional posterior plating for diaphyseal fracture humerus- A prospective randomized trial

Author(s): GAURAV SHARMA, AKSHAY SHAH, ABHAY CHHALLANI, RAHUL KADAM, TANMAY ASAWA, PRAVEEN KUMAR ANBALAGAN

Background: The present study aims to assess the mid-term outcome in patients with diaphyseal humerus shaft fractures treated with minimally invasive anterior bridge plating versus conventional posterior plate.

Methodology: 60 consecutive patients with closed diaphyseal fracture shaft humerus were included between February 2016 and January 2019 at a tertiary care center. Patients with compound fractures, neurovascular injury, ipsilateral limb injuries, were excluded from the study. The patients were block randomized into group I (anterior bride plating) and group II (posterior plating).

Results: The mean age of the patients was 48.16 ± 8.66 in group I and 45.10 ± 9.56 years in group II respectively. AO-OTA type 12A was most commonly seen fracture type. The mean surgical time in group I was 55.80 ± 6.23 minutes while it was 85.31 ± 7.67 minutes in group II was significant (p<0.001). Patients in group I had shorter hospital stay (p=0.018). Group I has a mean union rate of 14.57 ± 1.72 while group II had a rate of 15.67 ± 2.41 weeks (p=0.046). One patient in each group had non-union. One patient in group I had lateral antebrachial cutaneous nerve injury with some residual sensory loss. There was a significant improvement in DASH scores in both groups (p=0.0043).

Conclusion: The anterior bridge plating is a reliable and reproducible technique with shorter operative time, hospital stay, early radiological union and better outcome as compared to traditional posterior compression plating.