Locked and Compression Plating for Fractures of the Diaphyseal Humerus in the Elderly Patients: A Retrospective Study of 31 Patients

Background: Humeral shaft fractures are relatively common geriatric fractures. Theoretically, locked constructs have superior fixation strength. Objectives: This study aims to assess the clinical and radiographic differences between locking compression plating (LCP) and conventional dynamic compression plating (DCP) for fractures of the diaphyseal humerus in elderly patients. Materials and Methods: Between April 2015 and October 2020, 31 consecutive older patients (aged above 60 years) with displaced humeral shaft fractures underwent plate osteosynthesis in our institute. They were placed into one of the two treatment groups, depending on whether LCP or DCP was used. The Constant and Disabilities of the Arm, Shoulder, and Hand (DASH) scores were recorded for clinical assessment. Moreover, fracture union and radiographic complications were recorded for radiographic assessment. No significant differences were observed between the groups in terms of demographic data and duration of follow-up. Results: No significant differences between the groups were observed with regard to operative time ( P = 0.374), blood loss ( P = 0.949), hospital stay ( P = 0.754), union time ( P = 0.768), and revision surgery ( P = 0.631). However, patient outcomes of the LCP group were superior to those of the DCP group in terms of DASH score ( P = 0.002), Constant scores ( P = 0.008), and radiographic complications ( P = 0.02). Nonunion was reported in two patients, both of whom were in the DCP group. One periprosthetic fracture occurred at the proximal plate tip in the LCP construct group. Conclusions: In this study, LCP exhibited clinical and radiographic superiority over DCP in treating elderly fractures of the diaphyseal humerus. However, attention should be paid to the working length of plates when using locked constructs in the osteoporotic humeral shaft.