Published: 2017-02-22

Comparative study of surgical management of humeral shaft fractures with dynamic compression plate in Henry’s and Thompson’s approach in adults

C. D. Deepak, Mahesh D. V., Abdul Ravoof, Sankosh Krishna Sai


Background: Fractures of the humeral shaft account for roughly 3% to 5% of all fractures. The predominant causes of humeral shaft fractures include simple falls or rotational injuries in the older population and higher energy mechanisms in the younger patients including motor vehicle accidents, assaults, fall from height and throwing injuries. Treatment options for humeral fractures vary according to the type of fracture, age group, bone density, soft tissue status and associated complications. Surgical management of shaft humerus fractures by plating can be done mainly through Thompson’s (posterior) approach and Henry’s (antero-lateral) approach.

Methods: The study was conducted in patients treated for shaft humerus fracture at Adhichunchanagiri Institute of Medical Science, BG Nagara from the month of August 2014 to January 2016. Twenty patients diagnosed as shaft humerus fracture were taken into the study, all were undergone open reduction and internal fixation using dynamic compression plate in Thompson’s and Henry approach. Patients’ age more than 18 years were taken up for the study. Patients were followed up at 3 weeks, 6 weeks, 6 months.

Results: The sample consisted of twenty shaft humerus fracture patients with 10 males and 10 females. The patients’ ages were more than 18 years where 13 cases (65%) between 26 to 55 years. Among these 20 patients, 10 involved the right side and 10 involved the left side. All patients achieved clinical and radiological union at 6 month follow up. According to Constant Murley Score, excellent result were found in 11 patients (55%), good in 2 patients (10%) and fair in 7 patients (35%). According to Mayo elbow performance index, 17 patients showed excellent outcome (85%) and 3 patients showed good outcome (15%).

Conclusions:Dynamic compression plating is the best modality of management for the internal fixation of humeral shaft fractures. It is found that the fracture fixation of upper and middle one-third humerus in Henry’s approach is easier, lower one-third humeral fractures are not possible because the plate at the supracondylar ridge poses difficulty to fix. Fracture fixation of the lower one third and middle one third is easier in Thompson’s approach because of the flat surface of the bone and offers better plate contour.



Fracture shaft humerus, Dynamic compression plate, Thompson approach, Henry’s approach

Full Text:



Ekholm R, Adami J, Tidermark J, Hansson K, Törnkvist H, Ponzer S. Fractures of the shaft of the humerus: An epidemiological study of 401 fractures. J Bone Joint Surg Br. 2006;88:1469-73.

Tytherleigh-strong G, Walls N, McQueen MM. The epidemiology of humeral shaft fractures. J Bone and Joint Surg Br. 1998;80:249-53.

Carroll EA, Schweppe M, Langfitt M, Miller AN, Halvorson JJ. Management of humeral shaft fractures. J Am Acad Orthop Surg. 2012;20:423–33.

Lawless M, Gellman H. Midshaft Humerus Fractures Treatment & Management. Available at Accessed on 25 December 2016.

Denard A, Richards J, Obremskey W, Tucker M, Floyd M, Herzog G. Outcome of Nonoperative vs Operative Treatment of Humeral Shaft Fractures: A Retrospective Study of 213 Patients. Orthopedics. 2010;33(8):doi: 10.3928/01477447-20100625-16.

Hee HT, Low BY, SeeHF. Surgical results of open reduction and plating of humeral shaft fractures. Am Acad Med Singapore. 1998;27(6):772-5.

Meekers FS, Broos PL. operative treatment of humeral shaft fractures. The Leuven experience. Acta Orthop Belg. 2002;68(5):462-70.

Raghavendra S, Bhalodiya HP. Internal fixation of fractures of the shaft of the humerus by dynamic compression plate or intramedullary nail: A prospective study. Indian J Orthop. 2007;41:214-8

McCormack RG, Brein D, Buckley RE, McKee MD, Powell J. Fixation of fractures of the shaft of humerus by dynamic compression plate or intramedullary nail: a prospective, randomized trial. J Bone Joint Surg. 2000;82(3):336-9.

Vander Griend R, Tomsain J, Ward EF. Open reduction and internal fixation of humeral shaft fractures: Results using AO plating techniques. J Bone Joint Surg Am. 1986;68(3):430-3

Heim D, Herkett F, Hess P, Regazzoni P. Surgical treatment of humeral shaft fractures. The Basel experience. J Trauma. 1993;35(2):226-32.