Minimally invasive plating osteosynthesis (MIPO) of middle and distal third humeral shaft fractures

An Zhiquan, Zeng Bingfang, Wang Yeming, Zhang Chi, Huang Peiyan
Journal of Orthopaedic Trauma 2007, 21 (9): 628-33

OBJECTIVE: To evaluate the clinical, radiographic, and functional outcomes of middle and distal third humeral shaft fractures treated with the minimally invasive percutaneous osteosynthesis (MIPO).

DESIGN: Prospective, single-center, nonconsecutive clinical series study.

SETTING: : Skeletal trauma center of a university teaching hospital.

PATIENTS: Thirteen patients who were seen from May 2004 to October 2005 with an average age of 38.1 years (range, 25 to 60 years) form the basis of this study. Patients were obtained from a surgical database of 1 surgeon.

INTERVENTION: The middle and the distal third humeral shaft fractures were reduced by closed means and fixed with long narrow 4.5-mm dynamic compression plates introduced through 2 small incisions away from the fracture sites and placed on the anterior aspect of the humerus.

MAIN OUTCOME MEASUREMENTS: Time to fracture healing and functional assessments were assessed at an average follow-up of 12.5 months (range, 7 to 19 months) for the affected shoulders and elbows using the UCLA and Mayo elbow performance scoring systems, respectively.

RESULTS: All fractures united with a mean healing time of 16.2 weeks (range, 12 to 32 years). There were no nonunions, radial nerve palsies, or implant failures. The UCLA scoring system showed excellent results in 7 cases (53.8%) and good results in 6 cases (46.2%). Thirteen patients had excellent results of their elbow function when assessed with the Mayo elbow performance scoring system.

CONCLUSION: Closed reduction and internal fixation of middle or distal third humeral shaft fractures using MIPO is a safe and effective surgical treatment method and an alternative option to open techniques.

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