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. 2010 Feb;34(1):131-5.
doi: 10.1007/s00264-009-0753-x. Epub 2009 Mar 20.

Plating osteosynthesis of mid-distal humeral shaft fractures: minimally invasive versus conventional open reduction technique

Zhiquan An  1 , Bingfang Zeng, Xiaojian He, Qi Chen, Shundong Hu
Affiliations

Plating osteosynthesis of mid-distal humeral shaft fractures: minimally invasive versus conventional open reduction technique

Zhiquan An et al. Int Orthop. 2010 Feb.

Abstract
in English, French

Results of two methods, conventional open reduction-internal plating and minimally invasive plating osteosynthesis (MIPO), in the treatment of mid-distal humeral shaft fractures were compared. Thirty-three patients were retrospectively analysed and divided into two groups. Group A (n = 17) patients were treated by MIPO and group B (n = 16) by conventional plating. The mean operation time in group A was 92.35 +/- 57.68 minutes and 103.12 +/- 31.08 minutes in group B (P = 0.513). Iatrogenic radial nerve palsy in group A was 0% (0/17) and 31.3% in group B (5/16 (P = 0.012). The mean fracture union time in group A was 15.29 +/- 4.01 weeks (range 8-24 weeks), and 21.25 +/- 13.67 weeks (range 10-58 weeks) in group B (P = 0.095). The mean UCLA end-result score in group A was 34.76 +/- 0.56 points (range 33-35), and 34.38 +/- 1.41 points (range 30-35) in group B (P = 0.299). The mean MEPI in group A was 99.41 +/- 2.43 points (range 90-100) and 99.69 +/- 1.25 points (range 95-100) in group B ( P = 0.687). When compared to the conventional plating techniques, MIPO offers advantages in terms of reduced incidence of iatrogenic radial nerve palsies and accelerated fracture union and a similar functional outcome with respect to shoulder and elbow function.

Les résultats de deux méthodes d’ostéosynthèse par plaques après réduction sanglante conventionnelle voie mini-invasive (MIPO) dans le traitement des fractures médio-diaphysaires de l’humérus ont été comparées. 33 patients ont été revus rétrospectivement et analysés et divisés en deux groupes : le groupe A (n = 17), traité par MIPO et le groupe B (n = 16) traité de façon conventionnelle. Le temps opératoire moyen dans le groupe A était de 92,35 +/−57,68 minutes et 103,12+/−31,08 minutes dans le groupe B (P = 0,513). Il n’a pas été observé de paralysies iatrogéniques du nerf radial dans le groupe A, par contre, dans le groupe B sont survenues 31,3% de paralysies 5/16 (p = 0,012). Le temps moyen de consolidation dans le groupe A a été de 15,29+/−4,01 semaines (8 à 24 semaines) et, dans le groupe B, de 21,25+/−13,67 semaines (10 à 58 semaines) (P = 0,095). Le score final UCLA dans le groupe A était de 34,76+/−0,56 points (33 à 35 points) et dans le groupe B de 34,38+/−1,41 points (30 à 35) (P = 0,299). Le MEPI moyen dans le groupe A a été de 99,41+/−2,43 points (de 90 à 100) et dans le groupe B de 99,69+/−1,25 points (95 à 100) (P = 0,687). Si l’on compare les deux techniques, la technique par voie mini-invasive (MIPO) permet de réduire la fréquence des paralysies du nerf radial, permet une consolidation plus rapide et une fonction similaire notamment au niveau de l’épaule et du coude.

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Figures

Fig. 1
Fig. 1
A 34-year-old man whose arm was rolled into a machine and was treated with the MIPO technique. a Preoperative radiograph shows a distal third humeral shaft fracture (OTA 12B1.3). b,c Radiographic results at eight months after surgery. d Appearance of the incisions after surgery
Fig. 2
Fig. 2
a A distal third fracture of the right humeral shaft (OTA 12B2.3) of a 44-year-old male, crushed by heavy plate, was treated with open reduction and internal fixation with a plate. b Twelve months after surgery, the fracture line was still clear and loosening of proximal screws was identified
See this image and copyright information in PMC

Comment in

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