Minimally Invasive Plate Osteosynthesis of Proximal, Middle and Distal Humerus Fractures

Abstract

Purpose:The purpose of this study is to evaluate the clinical and radiological outcomes of proximal, middle and distal third humeral fractures treated with the minimally invasive plate osteosynthesis (MIPO). Materials and Methods: Thirty-one patients with the proximal, middle or distal third humeral fractures underwent MIPO. There were 12 men and 19 women with an average age of 46.7 years. The radiological outcomes of bony union and anatomical reduction were evaluated. The clinical outcomes were assessed by measuring the range of shoulder and elbow motion, UCLA scores, KSS sores and the postoperative complications. Results: Fracture union was obtained in all patients at an average of 18.4 weeks. According to the UCLA scores, 9 were excellent and 3 were good for the proximal humeral fractures. For the middle and distal third fractures, UCLA scoring system showed excellent results in 15 cases and good results in 4 cases. The average KSS scores of proximal and shaft fracture were 92.5 and 98.6, respectively. Complications developed in 3 patients: one had radial nerve palsy, one had a fracture adjacent to the plate distally, and one had a rotational deformity. Conclusion: MIPO for proximal, middle and distal third humeral fractures provided satisfactory clinical and radiological outcomes considering high union rate and minor complications.

A prospective study of functional, clinical, and radiological outcome of fracture shaft of humerus middle & distal one third treated by mippo technique

“…In our clinical study, 20 patients who sustained middle and distal one third humeral shaft fractures were treated with the MIPPO technique. All the fractures united with a mean healing of 17.84 weeks (range 12 -32 weeks), which is almost comparable to that reported by Zhiquan A et al [1] -16.2 weeks (range 12 to 32 weeks) and Sang-Jin shin et al [8] -18.4 weeks. The mean operating time in our study was 100.50 minutes (range 70 -140 min), whereas in Zhiquan A et al [1] , it was 113.8 minutes (70-160 min), and Fang Ji et al [2] , it was only 48 minutes (35-90 min) In our study, we encountered 2 cases of radial nerve dysfunction post-operatively, which recovered after 6-12 weeks in one case and 6 months in another case after exploration, whereas Zhiquan A et al [1] and Apivatthakakkul et al 4,5 reported no cases of radial nerve dysfunction after surgery.…”

“…Livani et al [7] reported good results in 35 cases of middle and distal third humeral shaft fractures without any iatrogenic radial nerve lesions. In Sang-Jin shins et al [8] study one patient had radial nerve palsy. In the reviewed literature, there were no reports of non-union after MIPPO technique.…”

“…In Zhiquan A et al [1] study, UCLA scoring system rated seven patients (63.8%) as excellent results and six (46.2%) as good results. In Sang-Jin shin et al study [8] (31 patients) -9 were excellent and 3 were good for the proximal humeral fractures, excellent results in 15 cases and good in 4 cases for middle and distal third fractures. Where as in our study the UCLA scoring system showed excellent results in nine cases (45 %) and good results in seven cases (35%) and fair in 4 cases (20%).…”

The application of a dual-lead locking screw could enhance the reduction and fixation stability of the proximal humerus fractures: a biomechanical evaluation

“…The proximal humerus fracture is one of the major osteoporotic fractures among older adults (1)(2)(3)(4). Aging could decrease bone mineral density (BMD) and increase osteoporosis risk.…”