Axillary nerve elongation in humeral fracture plating: A cadaveric study for comparison between straight and helical Philos plates.

Dauwe, Jan; Grechenig, Peter; Unterfrauner, Ines; Schwarz, Angelika; Weiglein, Andreas; Hohenberger, Gloria · J Orthop · 2020

biomechanical · Level V

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Abstract

Helical plating is a known concept in humeral fracture treatment. Attention should be paid to the axillary nerve when inserting a plate underneath the deltoid muscle. The purpose of this cadaveric study was to estimate axillary nerve stretching when introducing the plate. On 42 fresh frozen human humeri, an 8-, 10- and 12-hole Philos plate in a straight and a helical shape were compared measuring the maximum plate-bone-distance. For all three plate lengths, the helical plates had a significantly lower plate-bone-distance. Indirectly, this suggests a lower axillary nerve elongation and hence less chance of nerve damage.

Anatomy