Dual Plating versus Single Plating in the Management of Extra-articular Distal Humerus Fractures

Background: The management of extra-articular distal humerus fractures presents significant challenges due to the anatomical complexity of the elbow joint and associated risks. This study aims to compare the radiological and functional outcomes of different surgical modalities used in treating these fractures. Materials and Methods: A prospective study was conducted on 50 patients with extra-articular distal humerus fractures. Patients were divided into two groups: single plating (extra-articular distal humerus locking plate or DCP/LCP) and dual plating. Outcomes were assessed based on evidence of union by radiological evaluation, and functional recovery using the Disabilities of the Arm, Shoulder, and Hand (DASH) score and Mayo Elbow Performance Score (MEPS). Results: The average age of patients was 40.3 years, with a male predominance (78%). Dual plating had a significantly longer mean duration of surgery compared to single plating, greater blood loss, and longer postoperative hospital stay. Despite these drawbacks, dual plating demonstrated superior functional outcomes initially, as evidenced by a lower DASH score and higher MEPS. The union rate was high, and postoperative complications were less in both the groups, with dual plating showing marginally better early mobilization outcomes. Conclusions: Dual plating for extra-articular distal humerus fractures provides better functional outcomes and greater stability than single plating despite longer surgical times and increased blood loss. However, the difference was not statistically significant in the 9 th month and the later follow-ups and has similar outcomes and range of motion. Single plating is suitable for younger patients with good bone quality. The study emphasizes the importance of choosing the appropriate surgical technique based on patient-specific factors to achieve optimal recovery and functionality.