J Korean Fract Soc.  2011 Oct;24(4):341-346.

Minimally Invasive Anterior Plating of Humeral Shaft Fractures

• Lee HJ
• Oh CW
• Kim DH
• Park KH

Abstract

PURPOSE
We evaluated the efficacy and results of minimally invasive anterior plating for humeral shaft fracture.
MATERIALS AND METHODS
Twenty-two cases of humeral shaft fracture were reviewed, including 8 cases of type A, 8 of type B and 6 of type C (AO/OTA classification). There were three open fractures. The fracture was fixed with MIPO (minimally invasive plate osteosynthesis) technique under C-arm guide. A locking compression plate was located in anterior aspect of the humerus with at least three screws fixed in each fragment. Radiologic and functional results were evaluated.
RESULTS
In 20 of 22 cases, bony union was achieved with the mean period of 17.5 weeks, including 2 cases of delayed union. There were 2 cases of nonunion, which needed the further operative procedure. Except one case of distal 1/3 fracture, all cases showed satisfactory elbow and shoulder function with the mean Mayo elbow score of 17.4 and mean UCLA shoulder score of 97.3. In complication, there was one case of radial nerve palsy due to improper traction, but it was completely improved after 3 months. Otherwise, there was no complication including infection.
CONCLUSION
Anterior MIPO for humeral shaft fracture may be another option of operative methods with high union and low complication rate.

Keyword

MIPO; Humeral shaft fracture; Locking compression plate

MeSH Terms

Elbow
Fractures, Open
Humerus
Paralysis
Radial Nerve
Shoulder
Surgical Procedures, Operative
Traction

Figure

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  Fig. 1 (A) A 47-year-old female sustained a spiral fracture of the left humerus diaphysis due to in-car accident. (B, C) Through the submuscular tunnel, a locking compression plate was inserted and fixed with an acceptable alignment.

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  Fig. 2 (A) Ten months after the surgery, radiographs demonstrated a complete osseous union. (B) Note the skin scars of proximal and distal incision without involving the fracture site.

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  Fig. 3 (A) A 34-year-old female sustained a comminuted fracture of the humeral shaft after traffic accident. (B) After making the submuscular tunnel using Kelly clamps, a locking compression plate was fixed with the MIPO procedure. (C) Note an acceptable alignment without reducing the comminuted fragment.

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  Fig. 4 (A) Six months after the surgery, the osseous union was achieved. (B) Note the small incision scars of proximal and distal incision. (C) Note the firm union after the removal of plate.

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