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. 2009 Dec;33(6):1719-23.
doi: 10.1007/s00264-008-0616-x. Epub 2008 Aug 13.

Is MIPO in humeral shaft fractures really safe? Postoperative ultrasonographic evaluation

Bruno Livani  1 , William Belangero, Kleber Andrade, Guilherme Zuiani, Raphael Pratali
Affiliations

Is MIPO in humeral shaft fractures really safe? Postoperative ultrasonographic evaluation

Bruno Livani et al. Int Orthop. 2009 Dec.

Abstract
in English, French

In the last few years there has been great interest in minimally invasive plate osteosynthesis (MIPO) in the treatment of humeral shaft fractures. None of these studies showed the anatomical relationship between the radial nerve and the material of the implant in vivo. We performed postoperative ultrasonographic measurement of the distance between the radial nerve and the material implanted using the MIPO technique. Nineteen patients underwent postoperative ultrasound examinations. Group A comprised midshaft fractures and group B distal third fractures. The point of greatest proximity between the radial nerve and the implant was measured. In group A the distance was between 1.6 and 19.6 mm (mean: 9.3 mm) and in group B between 1.0 and 8.1 mm (mean: 4.0 mm). The ultrasound findings reveal that the radial nerve is quite close to the implant material, especially in the transition between the third and fourth quarters of the humeral shaft.

Ce travail est l’étude par ultrasonographie des rapports entre le nerf radial et la plaque implantée par technique mini invasive (MIPO) dans le traitement des fractures de la diaphyse humérale. Dix neuf patients sont étudiés avec fracture à mi-diaphyse pour le groupe A et fracture du 1/3 distal pour le groupe B. Le point de plus grande proximité entre l’implant et le nerf a été mesuré: entre 1,6 et 19,6 mm pour le groupe A (moyenne 9,3 mm) et entre 1,0 et 8,1 mm pour le groupe B (moyenne 4,0 mm). L’étude montre la proximité entre le nerf radial et le matériel surtout à l’union 3/4 proximal et 1/4 distal.

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Figures

Fig. 1
Fig. 1
a Plate on the anterior surface of humeral shaft. b Clinical example of a midshaft fracture treated by MIPO (group A)
Fig. 2
Fig. 2
a Plate on the anterior surface of lateral column of humeral shaft. b Clinical example of distal third fracture treated by MIPO (group B)
Fig. 3
Fig. 3
Anatomical piece of a distal fourth humeral shaft cut showing the close relationship between the radial nerve (narrow arrow) and the plate (broad arrow) inserted on the anterior surface of humeral shaft
See this image and copyright information in PMC

References

    1. Apivatthakakul T, Arpornchayanon O, Bavornratanavech S. Minimally invasive plate osteosynthesis (MIPO) of the humeral shaft fracture. Is it possible? A cadaveric study and preliminary report. Injury. 2005;36(4):530–538. doi: 10.1016/j.injury.2004.05.036. - DOI - PubMed
    1. Bodner G, Buchberger W, Schocke M, Bale R, Huber B, Harpf C, Gassner E, Jaschke W. Radial nerve palsy associated with humeral shaft fracture: evaluation with US-initial experience. Radiology. 2001;219(3):811–816. - PubMed
    1. Bodner G, Huber B, Schwabegger A, Lutz M, Waldenberger P. Sonographic detection of radial nerve entrapment within a humerus fracture. J Ultrasound Med. 1999;18(10):703–706. - PubMed
    1. Fernández Dell’Oca AA. The principle of helical implants. Unusual ideas worth considering. Injury. 2002;33(Suppl 1):SA1–SA27. - PubMed
    1. Hernández S, Dario R. Placa puente en húmero. Perspectiva de una técnica. Rev Colomb Ortop Traumatol. 2003;17(3):69–73.

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