Minimal invasive ostheosintesis for treatment of diaphiseal transverse humeral shaft fractures

Abstract

OBJECTIVE: To evaluate patients with transverse fractures of the shaft of the humerus treated with indirect reduction and internal fixation with plate and screws through minimally invasive technique. METHODS: Inclusion criteria were adult patients with transverse diaphyseal fractures of the humerus closed, isolated or not occurring within 15 days of the initial trauma. Exclusion criteria were patients with compound fractures. RESULTS: In two patients, proximal screw loosening occurred, however, the fractures consolidated in the same mean time as the rest of the series. Consolidation with up to 5 degrees of varus occurred in five cases and extension deficit was observed in the patient with olecranon fracture treated with tension band, which was not considered as a complication. There was no recurrence of infection or iatrogenic radial nerve injury. CONCLUSION: It can be concluded that minimally invasive osteosynthesis with bridge plate can be considered a safe and effective option for the treatment of transverse fractures of the humeral shaft. Level of Evidence III, Therapeutic Study.

Evaluation of the surgical treatment of humeral shaft fractures and comparison between surgical fixation methods

“…Tsai et al 7 analyzed the epidemiology of humeral shaft fractures over a five-year period in Taiwan and reported a predominance in men in the third decade of life; those authors suggested a correlation with the difference in age distribution among countries where the data were collected. Studies presenting surgical results in smaller samples, such as those by Connolly et al 8 (53 patients), Kumar et al 9 (30 patients), and Zogaib et al 10 (22 patients), are in agreement with the distribution observed in the present study, with a predominance of males between the third and fourth decades of life. A lower mean age and a higher male prevalence may be related to higher-energy trauma and to cases that were not susceptible to conservative treatment.…”

Radial nerve palsy associated with closed humeral shaft fractures: a systematic review of 1758 patients

“…One study was written in German [ 49 ], and the remaining studies were written in English. 24 studies were conducted in Asia [ 11 – 13 , 15 – 18 , 20 , 22 – 25 , 27 , 30 , 31 , 33 , 36 – 38 , 40 – 42 , 44 , 46 , 48 ], six in Europe [ 21 , 32 , 39 , 45 , 47 , 49 ], five in South-America [ 14 , 19 , 26 , 34 , 43 ], three in North-America [ 9 , 10 , 35 ] and one in Africa [ 8 ].…”

“…22 studies reported on primary RNP [ 9 – 12 , 14 , 16 , 18 , 20 , 22 , 23 , 26 , 33 – 35 , 37 – 40 , 43 , 45 , 47 , 49 ]. These studies consisted of 922 patients of which 88 presented with primary RNP (10%) (Table 3 ).…”

“…17 studies [ 8 , 14 , 17 , 19 , 24 , 26 , 27 , 30 – 32 , 34 , 36 , 39 , 43 , 44 , 46 , 48 ] reported on the effect of minimally invasive plate osteosynthesis, consisting of 436 patients. In 12 patients (3%), treatment was complicated by secondary RNP.…”

“…The most recent review investigating RNP in humeral shaft fractures dates to 2013 [5]; however, over the last 6 years 20 studies have been added to potentially contribute to our understanding [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27]. Therefore, the primary aim of this study was to systematically review all contemporary evidence to assess the incidence and recovery rate of primary and secondary RNP in closed humeral shaft fractures.…”