Dual Plating Vs Single Plating in Distal Humerus Fracture: A Retrospective Comparative Study at A Tertiary Care Hospital in Mumbai

Background: Distal humerus fractures present surgical challenges due to complex anatomy and the need for stable fixation for early mobilization. Dual plating is traditionally preferred for biomechanical stability, but single plating with locking plates is emerging as a less invasive alternative. This study compared clinical, radiological, and functional outcomes of dual versus single plating in a tertiary care setting in Mumbai. Material and Methods: This retrospective comparative study included 48 adults (18–65 years) with distal humerus fractures (AO types A2, A3, C1–C2) treated over one year. Patients were divided into dual plating (n=24) and single plating (n=24) groups. Outcomes assessed included operative time, blood loss, union rates, complications, and functional scores (MEPS, DASH) at up to 12 months. Statistical analysis was performed using SPSS v25 with p<0.05 considered significant. Results: The mean age was comparable between groups, with a male predominance and road traffic accidents as the primary cause (75%). Dual plating had significantly longer operative time (102 ± 18 vs 63 ± 14 minutes, p<0.001) and higher blood loss (285 ± 65 vs 165 ± 48 ml, p<0.01). Union rates were similar (95.8% vs 91.7%, p=0.55), with comparable time to union. Functional outcomes were also similar, with good-to-excellent MEPS in 83.3% (dual) and 79.2% (single) (p=0.72), and comparable DASH scores. Complications were more frequent in the dual plating group, though not statistically significant. Conclusion: Both techniques provided satisfactory outcomes. Single plating offered advantages of reduced operative time and blood loss with comparable functional results, suggesting it as a viable option in selected cases.

Keywords: Distal humerus fracture, dual plating, single plating, ORIF, MEPS, functional outcome, Mumbai study.