RT Journal Article
SR Electronic
T1 Subbrachial approach to humeral shaft fractures: new surgical technique and retrospective case series study
JF Canadian Journal of Surgery
JO CAN J SURG
FD Canadian Medical Association
SP 27
OP 34
DO 10.1503/cjs.011911
VO 56
IS 1
A1 Vladimir Boschi
A1 Zenon Pogorelic
A1 Gordan Gulan
A1 Katarina Vilovic
A1 Hrvoje Stalekar
A1 Kanito Bilan
A1 Leo Grandic
YR 2013
UL http://canjsurg.ca/content/56/1/27.abstract
AB Background: There are few surgical approaches for treating humeral shaft fractures. Here we present our results using a subbrachial approach.Methods: We conducted a retrospective case series involving patients who had surgery for a humeral shaft fracture between January 1994 and January 2008. We divided patients into 4 groups based on the surgical approach (anterior, anterolateral, posterior, subbrachial). In all patients, an AO 4.5 mm dynamic compression plate was used.Results: During our study period, 280 patients aged 30–36 years underwent surgery for a humeral shaft fracture. The average duration of surgery was shortest using the subbrachial approach (40 min). The average loss of muscle strength was 40% for the anterolateral, 48% for the posterior, 42% for the anterior and 20% for the subbrachial approaches. The average loss of tension in the brachialis muscle after 4 months was 61% for the anterolateral, 48% for the anterior and 11% for the subbrachial approaches. Sixteen patients in the anterolateral and anterior groups and 6 patients in the posterior group experienced intraoperative lesions of the radial nerve. No postoperative complications were observed in the subbrachial group.Conclusion: The subbrachial approach is practical and effective. The average duration of the surgery is shortened by half, loss of the muscle strength is minimal, and patients can resume everyday activities within 4 months. No patients in the sub-brachial group experienced injuries to the radial or musculocutaneous nerves.