Double Screws technique for management of unstable transverse humeral fractures: A comparative study

Abstract

Background
Plate osteosynthesis is considered the gold standard treatment for unstable humeral shaft fracture. During the surgery, it is usually advisable to achieve a preliminary reduction while applying compression on the fracture site before the plate application. While this can be easily achieved in oblique and spiral fractures using the interfragmentary screws, it is almost impossible to achieve in the transverse fractures. As a result, we introduce the Double Screws (DS) technique as a reliable solution for this problem comparing it with the traditional indirect reduction by the plate itself.


Materials and methods:
Patients with unstable transverse humeral shaft fractures admitted at Mansoura Trauma and Emergency Hospital during the period from July 2020 to July 2021 were collected. They were divided into two groups: one for DS reduction technique and the other for the traditional indirect reduction by the plate. Results regarding operative time, intra-operative blood loss, healing, and other complications were reported.


Results:
the mean operative time was significantly lower in DS group being 101.3 ± 2.3 min compared to 120.4 ± 11.2 min in the traditional group (P=0.0015). Similarly, the mean blood loss was significantly lower in DS group being 320.9 ± 15.7 ml compared to 344.16 ± 15.6 ml in the traditional group (P=0.0035). Time to union was comparable being 14.8 ± 0.8weeks and 14.3 ± 1.6weeks in the DS and traditional groups respectively (P=0.46).


Conclusion
DS technique is considered a reliable, time efficient and less bloody method for reduction of unstable transverse fracture pattern of humeral diaphysis.