Rotational evaluation of humeral shaft fractures with proximal extension fixed using the MIPO technique

Zamboni, Caio; Durigan, Jorge Rafael; Pimentel, Felipe Diaz; Hungria, José Octávio Soares; Mercadante, Marcelo Tomanik; Fucs, Patrícia Maria de Moraes Barros

doi:10.1016/j.injury.2018.06.017

Cited by 8 publications

(10 citation statements)

References 24 publications

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“…There are several different open fracture rat models modified from the classical model performing transverse osteotomy combined with skin incision and resections of muscle around the fracture site [10,21]. However, most models provided closed or open fractures with only minimal soft tissue injury which was not caused by high energy, and these models were made according to the anatomical characteristics step-by-step and could not mimic the clinic fractures which always occurred with corresponding soft tissue injuries in seconds.…”

Section: Discussionmentioning

confidence: 99%

“…After performing X-ray and computed tomography angiography (CTA) at 6 h, the fracture was stabilized individually. Generally, the closed simple fracture is prone to be stabilized by Scotchcast casting tape (3 M, Inc., USA), while an open and comminuted fracture would be stabilized by a retrograde intramedullary Kirschner wire (0.8 mm) in a sterile manner after debridement and reduction [10]. Furthermore, the wire was to be cut and bent back onto itself before the incision was closed with absorbable sutures (Vicryl, Ethicon, Inc., USA).…”

Section: Methodsmentioning

confidence: 99%

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A novel rat model of tibial fracture for trauma researches: a combination of different types of fractures and soft tissue injuries

et al. 2019

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BackgroundThe outcomes for open tibial fractures with severe soft tissue injury are still a great challenge for all the trauma surgeons in the treatment. However, most of the existing open tibial fracture models can only provide minimal soft tissue injury which cannot meet the requirement of severe trauma research. Our goal is to investigate a novel tibial fracture model providing different fractures combined with soft tissue injury for better application in trauma research.MethodsA total of 144 Sprague-Dawley rats were randomly divided into 4 groups. With group 1 as control, the other groups sustained different right tibial fractures by the apparatus with buffer disc settings either 3 mm, 10 mm, or 15 mm. X-ray and computed tomography angiography (CTA) were performed at 6 h to evaluate the fracture patterns and vascular injuries. Peripheral blood and tibialis anterior muscle were harvested at 6 h, 1 day, 3 days, 7 days, 14 days, and 28 days for ELISA and histological analysis.ResultsX-ray and μCT results indicated that different fractures combined with soft tissue injuries could be successfully provided in this model. According to OTA and Gustilo classification, the fractures and soft tissue injuries were evaluated and defined: 36 type I in group 2, 34 type II in group 3, and 36 type III in group 4. The CTA confirmed no arterial injuries in groups 1 and 2, 2 arterial injuries in group 3, and 35 in group 4. ELISA indicated that the levels of pro-inflammatory cytokines TNF-α and IL-1β were significantly higher in group 4 than in other groups, and the levels of anti-inflammatory cytokines TGF-β and IL-10 were significantly higher in surgery groups than in group 1 in later stage or throughout the entire process. HE, Masson, and caspase-3 stains confirmed the most severe inflammatory cell infiltration and apoptosis in group 4 which lasted longer than that in groups 2 and 3.ConclusionsThe novel apparatus was valuable in performing different fractures combined with soft tissue injuries in a rat tibial fracture model with high reproducibility and providing a new selection for trauma research in the future.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

A novel rat model of tibial fracture for trauma researches: a combination of different types of fractures and soft tissue injuries

et al. 2019

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“…have published two caseseries of 28 and 11 patients, respectively, treated with the anterolateral MIPO approach. 19 , 20 Zhao et al . emphasized that the small incision for the exploration of the radial nerve is essential to avoid nerve iatrogenic injuries or to decompress the nerve if it involved in the trauma (as in 5 of 28 patients, who recovered completely).…”

Section: Discussionmentioning

confidence: 99%

“…In particular, Zhao et al and Zamboni et al have published two caseseries of 28 and 11 patients, respectively, treated with the anterolateral MIPO approach. 19,20 Zhao et al emphasized that the small incision for the exploration of the radial nerve is essential to avoid nerve iatrogenic injuries or to decompress the nerve if it involved in the trauma (as in 5 of 28 patients, who recovered completely). 19 Zamboni et al analysed the difficulty of avoiding rotation errors with the MIPO technique, concluding that, even if this often happens, an increase in humeral head retroversion is well tolerated and does not lead to functional insufficiency of the shoulder.…”

Section: Discussionmentioning

confidence: 99%

“…19 Zamboni et al analysed the difficulty of avoiding rotation errors with the MIPO technique, concluding that, even if this often happens, an increase in humeral head retroversion is well tolerated and does not lead to functional insufficiency of the shoulder. 20 Similarly, Chang et al published a case-series of 38 patients treated with the MIPO lateral approach and small incision for radial nerve exploration and fracture reduction. Again, the results overlapped the previous ones, not reporting significant advantages over traditional approaches.…”

Section: Discussionmentioning

confidence: 99%

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Surgical approach for fracture of distal humerus: Posterior <em>vs</em> lateral

Saracco¹,

Smimmo²,

Marco³

et al. 2020

Orthop Rev (Pavia)

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Humeral fractures have an incidence of 3-5% and a bimodal age distribution. They may occur in young patients after highenergy traumas or in elderly osteoporotic patients after low-energy injuries. In nondisplaced fractures or in elderly patients, humeral fractures are treated by conservative methods. Open reduction and internal fixation (ORIF) should be the treatment of choice in case of multi-fragmentary fractures associated with radial nerve palsy or not. ORIF is usually regarded as the gold standard treatment, but, depending on the different types of fracture, the surgical approach can change. In this review, we compare results and complication rates between lateral and posterior surgical approaches in the management of extraarticular distal humeral shaft fractures. An internet-based literature research was performed on Pubmed, Google Scholars and Cochrane Library. 265 patients were enrolled: 148 were treated by lateral or antero-lateral approach, while 117 by posterior or postero-lateral approach. The literature shows that no differences between the posterior and lateral approach exist. Certainly, the posterior approach offers undoubted advantages in terms of exposure of the fracture and visualization of the radial nerve. In our opinion, the posterior approach may also allow better management of complex and multi-fragmentary fractures.

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A practical guide for the use of contour locking plates for the repair of humeral diaphyseal fractures with proximal extension

Zamboni

Carmo

Moraes

et al. 2019

Injury

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Rotational evaluation of humeral shaft fractures with proximal extension fixed using the MIPO technique

Cited by 8 publications

References 24 publications

A novel rat model of tibial fracture for trauma researches: a combination of different types of fractures and soft tissue injuries

A novel rat model of tibial fracture for trauma researches: a combination of different types of fractures and soft tissue injuries

Surgical approach for fracture of distal humerus: Posterior <em>vs</em> lateral

A practical guide for the use of contour locking plates for the repair of humeral diaphyseal fractures with proximal extension

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