A Clinical Study of Humeral Shaft Fractures Treated with Minimally Invasive Plate Osteosynthesis (MIPO) Technique
Authors/Creators
- 1. Assistant Professor, Department of Orthopedics, Rajiv Gandhi Institute of Medical Sciences (RIMS), Adilabad, Telangana State
- 2. Associate Professor, Department of Orthopedics, Rajiv Gandhi Institute of Medical Sciences (RIMS), Adilabad, Telangana State
Description
Background: The population is growing rapidly, and the number of vehicles on the road are increasing accordingly. As a result, the incidence of road traffic accidents and humerus fractures has also risen. Humeral shaft fractures are a frequent occurrence, representing approximately 1 to 3% of all fractures. There are various surgical methods available to treat humeral shaft fractures, including plate fixation, intramedullary nailing, and tens nailing. Biological union occurring at the fracture site is not interfered with by the recently discovered MIPO approach for treating humerus fractures. Methods: Successive cases of shaft of humerus fractures reported to our hospital were included. In all the cases the treatment of fractures was within 3 weeks of the injury. The fractures were classified based on the AO/ASIF (Arbeitsgemeinschaft fuer Osteosynthesefragen/ association for the study of internal fixation) classification system. All operations were performed by the same surgeon using the Standard technique for MIPO plating. Results: In this study, we found 72% of cases were with Good functional outcomes as evaluated by UCLA scores. The range of UCLA scores was from 29 to 35 and the mean scores were 33.2 ± 1.5 (table 3). Similarly, the MEPS scores were evaluated in this study we found all the cases were in Excellent/Good groups by MEPS scores and the range of scores were 80 – 100 and the mean score was 84.5 ± 2.5. In this study, we found the meantime for fracture healing was 14.55 ± 2.5 weeks the range of time was from 12.5 weeks to 16.0 weeks. The range of motion in degrees obtained in the cases of the study was from 115.0 ± 15.0 degrees and the mean range of motion was 123.5 degrees. Conclusion: Compared to the conventional methods of open reduction and internal fixation, the use of humerus MIPO plating yields favorable outcomes and leads to a faster recovery after surgery and minimal post-operative complications. Hence this method must be considered with priority in cases of fracture of the shaft of the humerus whenever feasible.
Abstract (English)
Background: The population is growing rapidly, and the number of vehicles on the road are increasing accordingly. As a result, the incidence of road traffic accidents and humerus fractures has also risen. Humeral shaft fractures are a frequent occurrence, representing approximately 1 to 3% of all fractures. There are various surgical methods available to treat humeral shaft fractures, including plate fixation, intramedullary nailing, and tens nailing. Biological union occurring at the fracture site is not interfered with by the recently discovered MIPO approach for treating humerus fractures. Methods: Successive cases of shaft of humerus fractures reported to our hospital were included. In all the cases the treatment of fractures was within 3 weeks of the injury. The fractures were classified based on the AO/ASIF (Arbeitsgemeinschaft fuer Osteosynthesefragen/ association for the study of internal fixation) classification system. All operations were performed by the same surgeon using the Standard technique for MIPO plating. Results: In this study, we found 72% of cases were with Good functional outcomes as evaluated by UCLA scores. The range of UCLA scores was from 29 to 35 and the mean scores were 33.2 ± 1.5 (table 3). Similarly, the MEPS scores were evaluated in this study we found all the cases were in Excellent/Good groups by MEPS scores and the range of scores were 80 – 100 and the mean score was 84.5 ± 2.5. In this study, we found the meantime for fracture healing was 14.55 ± 2.5 weeks the range of time was from 12.5 weeks to 16.0 weeks. The range of motion in degrees obtained in the cases of the study was from 115.0 ± 15.0 degrees and the mean range of motion was 123.5 degrees. Conclusion: Compared to the conventional methods of open reduction and internal fixation, the use of humerus MIPO plating yields favorable outcomes and leads to a faster recovery after surgery and minimal post-operative complications. Hence this method must be considered with priority in cases of fracture of the shaft of the humerus whenever feasible.
Files
IJTPR,Vol13,Issue5,Article4.pdf
Files
(351.3 kB)
| Name | Size | Download all |
|---|---|---|
|
md5:3758f103604e6d9995c7ffc38c1d7516
|
351.3 kB | Preview Download |
Additional details
Dates
- Accepted
-
2023-04-30
Software
References
- 1. Updegrove GF, Mourad W, Abboud JA. Humeral shaft fractures. J Shoulder Elbow Surg. 2018;27(4): e87–97. 2. Ouyang H, Xiong J, Xiang P, Cui Z, Chen L, Yu B. Plate versus intramedullary nail fixation in the treatment of humeral shaft fractures: an updated meta-analysis. J Shoulder Elbow Surg. 2013;22(3):387–95. 3. Gosler MW, Testroote M, Morrenhof JW, Janzing HM. Surgical versus nonsurgical interventions for treating humeral shaft fractures in adults. Cochrane Database Syst Rev. 2012;1: CD008832. 4. Allende C, Vanoli F, Gentile L, Gutierrez N. Minimally invasive plate osteosynthesis in humerus nonunion after intramedullary nailing. Int Orthop. 2018;42(11):2685–9. 5. McKee MD, Larsson S. Humeral shaft Fractures. Rockwood and Green's fractures in adults. Philadelphia: Lippincott Williams & Wilkins; 2010. 6. Siegel J, Tornetta P3, Borrelli JJ, Kregor P, Ricci WM. Locked and minimally invasive plating. Instr Course Lect. 2007; 56:353–68. 7. An Z, Zeng B, He X, Chen Q, Hu S. Plating osteosynthesis of mid-distal humeral shaft fractures: minimally invasive versus conventional open reduction technique. Int Orthop. 2010; 34(1):131–5. 8. Yigit S. What should be the timing of surgical treatment of humeral shaft fractures? Medicine (Baltimore). 2020 ;99(17): e19858. 9. Lode I, Nordviste V, Erichsen JL, Schmal H, Viberg B. Operative versus nonoperative treatment of humeral shaft fractures: a systematic review and metaanalysis. J Shoulder Elbow Surg. 2020;29(12):2495–504. 10. Lu S, Wu J, Xu S, Fu B, Dong J, Yang Y, Wang G, Xin M, Li Q, He TC, et al. Medial approach to treat humeral midshaft fractures: a retrospective study. J Orthop Surg Res. 2016; 11:32. 11. Lotzien S, Hoberg C, Rausch V, Rosteius T, Schildhauer TA, Gessmann J. Open reduction and internal fixation of humeral midshaft fractures: anterior versus posterior plate fixation. BMC Musculoskeletal Disorders. 2019; 20:1. 12. Oh CW, Byun YS, Oh JK, Kim JJ, Jeon IH, Lee JH, et al. Plating of humeral shaft fractures: comparison of standard conventional plating versus minimally invasive plating. Orthop Traumatol Surg Res. 2012;98(1):54–60. 13. kholm R, Tidemark J, Tornkvist H, Adami J, Ponzer S. Outcome after closed functional treatment of humeral shaft fractures. J Orthop Trauma. 2006; 20(9):591–6. 14. Toivanen JA, Nieminen J, Laine HJ, Honkonen SE, Jarvinen MJ. Functional treatment of closed humeral shaft fractures. Int Orthop. 2005;29(1):10–3. 15. Green A, Reid JP, DuWayne AC. Fractures of the humerus. Orthopedic knowledge update: trauma 3. Rosenmont: American Academy of Orthopedic Surgeons; 2000. 16. Sarmiento A, Zagorski JB, Zych GA, Latta LL, Capps CA. Functional bracing for the treatment of fractures of the humeral diaphysis. J Bone Joint Surg Am. 2000;82(4):478–86. 17. Papasoulis E, Drosos GI, Ververidis AN, Verettas DA. Functional bracing of humeral shaft fractures. A review of clinical studies. Injury. 2010;41(7): e21–7. 18. Kapil Mani KC, Gopal Sagar DC, Rijal L, Govinda KC, Shrestha BL. Study on the outcome of fracture shaft of the humerus treated nonoperatively with a functional brace. Eur J Orthop Surg Traumatol. 2013;23(3):323–28. 19. Spiguel AR, Steffner RJ. Humeral shaft fractures. Curr Rev Musculoskelet Med. 2012;5(3):177–83. 20. Bhandari M, Devereaux PJ, McKee MD, Schemitsch EH. Compression plating versus intramedullary nailing of humeral shaft fractures--a metaanalysis. Acta Orthop. 2006;77(2): 279–84. 21. Niall DM, O'Mahony J, McElwain JP. Plating of humeral shaft fractures--has the pendulum swung back? Injury. 2004;35(6):580–86. 22. Lim KE, Yap CK, Ong SC, Aminuddin. Plate osteosynthesis of the humerus shaft fracture and its association with radial nerve injury—a retrospective study in Melaka General Hospital. Med J Malaysia. 2001;56 Suppl C:8–12. 23. Jawa A, McCarty P, Doornberg J, Harris M, Ring D. Extra-articular distalthird diaphyseal fractures of the humerus. A comparison of functional bracing and plate fixation. J Bone Joint Surg Am. 2006;88(11):2343–47. 24. Walker M, Palumbo B, Badman B, Brooks J, Van Gelderen J, Mighell M. Humeral shaft fractures: a review. J Shoulder Elbow Surg. 2011;20(5): 8 33–44. 25. Malhan S, Thomas S, Srivastav S, Agarwal S, Mittal V, Nadkarni B, et al. Minimally invasive plate osteosynthesis using a locking compression plate for diaphyseal humeral fractures. J Orthop Surg (Hong Kong). 2012;20(3):292–96. 26. Shin SJ, Sohn HS, Do NH. Minimally invasive plate osteosynthesis of humeral shaft fractures: a technique to aid fracture reduction and minimize complications. J Orthop Trauma. 2012; 26(10):585–89.