A clinical study of minimal invasive anterior bridge plating for humerus shaft fractures

Abstract

Introduction: In humeral shaft fractures management anterior bridge plating is reported as an acceptable less traumatic and reproducible procedure by several authors. Our study done to evaluated the clinical, radiological, and functional outcome of such fractures in 10 patients, all of which were managed with dynamic compression plate over an average follow up period of 16 months. Though open reduction and plating technique of humerus shaft fracture is gold standard, this technique also gives good outcome. Materials and Methods: Ten patients with humerus shaft fractures were managed by anterior bridge plating using Minimum invasive osteosynthesis technique between Jan 2016 and April 2017 were included in this study. All cases were treated with closed reduction and 4.5mm dynamic compression plate fixation over anterolateral aspect in bridging mode using the MIPO technique. The dominant side, gender ratio, surgery time, radiation exposure, and fracture union time, and complications were noted. The UCLA shoulder and Mayo elbow performance scores were used for assessing the shoulder and elbow function. Results: Out of the ten patients in the study, seven were males and three were females. The mean age was 38 years (range 24 to 60 years). seven out of ten patients (70%) had the dominant side fractured. Mean surgical time in minutes was 80min (range: 60-100 minutes) and mean radiation exposure, in terms of one sec for each c-arm exposure was 88 seconds (range: 60-140 seconds).The mean fracture union (radiological) time was 11.6 weeks (range: 10-18 weeks). However Shoulder function was excellent to good in 9 cases (90%) and fair in 1 case (10%) on the UCLA score. Conclusion: There is high rate of union and excellent functional outcomes by this procedure. Minimal incision with this anterior bridge technique for fracture shaft humerus results in good functional outcomes and should be considered as an effective surgical option in the treatment of humeral shaft fractures. It is a safe and less time consuming method for simple types of humeral shaft fractures when the surgeon is experienced in the technique.

Prospective study of clinical, radiological and functional outcome of anterior bridge plating for shaft of humerus fracture

“…Most of the fractures (60%) in our study were united in 9-12 weeks. Similar observations were noted in the studies of Sharma et al, Vegad et al, Ibrahim et al, and Mahajan et al 18,20,21,26 At 18,26 Although the difference in the range of motion between the operated and non-operated sides was statistically significant, there was no clinical difference in subjective postoperative strength.…”