Minimally Invasive Plate Osteosynthesis of Humeral Shaft Fractures Clinical Results in a Regional Ho

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Minimally Invasive Plate Osteosynthesis of
Humeral Shaft Fractures Clinical Results in a
Regional Hospital

• Juan Manuel Concha, MD
• Alejandro Sandova, MD
• Philipp N Streubel, MD
• Universidad del Cauca
• Fundación Santa Fe de Bogotá
• AO Clinical Investigation
• Colombia / South America

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(No Transcript)
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Disclosure

• The authors have no potential conflict of
  interest with this presentation

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Humerus shaft fractures

• High union rates with nonoperative treatment
• Surgical indications
• Plating gold standard
• Healing 88-100
• Radial n. injury 0-6
• Infection up to 21
• Extensive disection

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Minimally Invasive Surgery

• Soft tissue preservation, no graft
• Anatomically safe
• Healing 90-100
• Radial n. injury 1 reported
• Small series 5 to 21 cases
• Reproducibility?
• Results published by few centers
• Referral hospitals

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Materials and Methods

• June 2004 to January 2007
• Humerus fractures treated with MIPO
• Follow-up gt 6 months
• Outcomes
• Healing
• Alignment
• Elbow ROM

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Surgical Approach
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Materials and Methods

• 35 patients
• 33 years (range 19-54)
• 26 males (74), 9 females (26)
• Mean follow-up 12 months (range 6-24)
• Plate type 26 conventional, 9 locked

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Materials and Methods
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Results
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Results Alignment

• Alignment gt5 12 patients
• 5 10
• 2 15
• 1 20 (malunion)
• Asymptomatic

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Results ROM

• ROM lt100 9 patients (26)
• 2 nonunions, 1 infection, 1 open III fracture
• 1 open fracture, 4 closed fractures (14)
• In all 20 extension lag

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Discussion

• Similar union rate as reported for complex
  humerus fractures
• Higher rates of angulation than
• reported for MIPO
• Higher rate of elbow stiffness

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Discussion

• MIPO effective for surgical treatment of humerus
  shaft fractures
• Demanding surgical technique
• Abduction avoid varus
• 30? elbow flexion, longitudinal traction sagital
  alignment
• Fluoroscopy adequate AP and lateral imaging
• Elbow stiffness
• Extension lag brachialis muscle scaring?
• Rehab indicated?

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Thank you