Implant failure within 3 days after plating of fracture shaft humerus

Fracture shaft of humerus is a relatively common long bone fracture accounting for 10 percent of long bone fractures. But unlike other long bone fractures, the uniqueness of this fracture is that most fractures are managed conservatively rather than operatively. Excellent functional outcomes and high rates of bony union have been reported by numerous studies for conservatively managed fractures. Nevertheless, in the subset of fractures that require open reduction and internal fixation, plating is the gold standard among surgeries with 92 to 96 percent success rate. Implant backing out after plating is rare and causes can be mechanical, biological, poor surgical technique, excessive/insufficient construct stiffness etc. But backing out of a plate usually appears after repeated cycles of mechanical loading and is a gradual process. Presented here is a rare case in which the plate backed out within 3 days after surgery and a discussion regarding the causes of this drastic complication.