EXTRA-ARTICULAR DUAL PLATING FOR INFECTIVE GAP NON-UNION IN DISTAL HUMERUS FRACTURE - A CASE REPORT

Introduction: Distal humerus fractures, especially those associated with complex soft tissue injuries, can present significant challenges in orthopaedic management. The Masquelet technique, a two-stage surgical approach utilizing induced membrane and bone grafting, has gained popularity for managing infected nonunion. However, stability after fixation remains a concern, particularly in cases with compromised bone stock. Extra-articular plating with bone grafting with an additional plate as a pillar is an emerging strategy for enhancing fixation in these challenging cases, offering biomechanical advantages in providing stability during the healing phase.

Case Report:A 30yr old male came with complaints of discharging wound from the right arm following two previous surgeries done more than a year ago.He had abnormal mobility at the fracture site with signs of radial and musculucutaneous nerve injury.On X-ray there was non -union of the distal 1/3 of shaft of humerus with implant failure .In the primary surgery Masquelet technique was used after extensive debridement .After 6 weeks when counts were normal ,CRP was normal and sinus completely healed, definitive fixation with dual plate and bone grafting was done.His radial nerve injury showed signs of recovery immediate post op.Although musculocutaneous nerve injury has not shown significant recovery immediately and is now showing signs of recovery. He is able to carry out his daily activities.

Result: Open Distal humerus fractures in a 30yr old male patient treated with Masquelet technique followed by open reduction and internal fixation with dual plate with bone grafting has shown good functional outcome in terms of union and early mobilisation with good range of motion.