Introduction: Humeral fractures are very rare accounting for less than 1% of fractures. The usual cause of capitellum and the trochleafractures of humeral is the result of axial loading. In 1996, Mckee proposed a category of humeral fractures mentioned as coronal shear fractures of the humerus. This category of fracture extends beyond the capitellum up to the trochlear ridge. Although surgeons have tried various options such as K-wires, mini fragment screws, headless compression screws and bio-absorbable implants. Herbert screw fixation has proved to be a promising option due to excellent compression at fracture site, stability and good intra-articular fixation.

Method: This cross-sectional study was performed at the Department of Orthopedics, Dr Ruth KM Pfau Civil Hospital Karachi.Patients with isolated coronal shear fractures were included in the study between ages 15-75 years.Open reduction and internal fixation was used and lateral approach was used as it offers better visualization.The mayo elbow performance index (MEPI) score was used to evaluate the post-operative functional outcome.

Results: A total of 12 cases presented during the study duration. The mean operating time was 85 ± 2 minutes. All patients had complete healing of the fracture. One patient developed post-traumatic osteoarthritis of the affected joint. During follow up, one patient develop moderate ache while routine activities. The pain was resolved at subsequent follow ups. The average loss of range of motion among affected patients was 5 degrees of flexion-extension and 8 degrees of supination-pronation. The average MEPS score was 93.4 +5.3.

Conclusion: Herbert screw fixation offers promising results with isolated coronal shear humeral fractures. All patients in our study has good functional outcome. One elderly patient developed post-traumatic osteo-arthritis of the affected joint.

Keywords: coronal shear fractures, Herbert screw fixation, capitellum fractures