scholarly journals Anterior humeral approach with nerve stimulator

2018 ◽  
Vol 26 (3) ◽  
pp. 230949901880300
Author(s):  
Murat Gulcek ◽  
Mehmet Gamli
Keyword(s):  
Minimally Invasive ◽  
Nerve Injury ◽  
Radial Nerve ◽  
Anterior Approach ◽  
Screw Fixation ◽  
Plate Osteosynthesis ◽  
Minimally Invasive Plate Osteosynthesis ◽  
Nerve Stimulator ◽  
Invasive Approach ◽  
Radial Nerve Injury

Introduction: The prevalence of radial nerve injury during surgery is as high as the prevalence of radial nerve injury due to trauma. The aim of this study is to minimize the risk of iatrogenic injury of radial nerve. Materials and Methods: Fifty patients with middle or distal diaphysis fractures of humerus and 18 patients with pseudoarthrosis at the same localizations were treated with surgery. Plate-screw fixation was performed with anterior approach in 43 patients. Eleven patients had minimally invasive plate osteosynthesis, and 14 patients had intramedullary nailing. The localization of the radial nerve was determined with nerve stimulator at the area of dissection. Results: Iatrogenic radial nerve injury did not occur in patients treated with open reduction or minimally invasive approach. Discussion: Nerve stimulator may be a method that decreases radial nerve injury, an iatrogenic complication. This method may be used in anterior approach and minimally invasive procedures.

scholarly journals Minimally Invasive Plate Osteosynthesis in Humeral Shaft Fractures via Anterior Approach

2021 ◽  
Vol 8 (13) ◽  
pp. 745-750
Author(s):  
Nikhilkumar Sureshkumar Oza ◽  
Ganesh A ◽  
Anand Kumar Singh ◽  
Pulin Bihari Das ◽  
Anurag Singh ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Scoring System ◽  
Radial Nerve ◽  
Anterior Approach ◽  
Plate Osteosynthesis ◽  
Case Series ◽  
Minimally Invasive Plate Osteosynthesis ◽  
Fracture Union ◽  
Excellent Outcome ◽  
Radial Nerve Injury

BACKGROUND This case series was conducted to evaluate the intraoperative and post-operative outcomes of fracture shaft of humerus managed by indirect reduction and minimally invasive plate osteosynthesis (MIPO) via anterior approach. METHODS In this case series 26 diaphyseal fractures of the humerus treated with MIPO, between June 2017 and February 2020 at a tertiary care hospital were included. All the patients were followed up for a minimum period of 2 years postoperatively. The objective was to evaluate these cases clinically for shoulder and elbow range of motion and document any complications. Other parameters such as duration of surgery and radiological time for fracture union were also documented. RESULTS The mean duration for surgery was 86.5 minutes. The University of California Los Angeles (UCLA) shoulder scoring system rated 18 patients (69.2 %) as excellent outcome, 07 patients (26.9 %) as good outcome, and 1 patient (3.8 %) as fair outcome. The MAYO Elbow Performance Scoring system rated 20 patients (76.9 %) as excellent outcome and 06 patients (23.1 %) as good outcome. About 96 % of patients achieved fracture union by the end of 16 weeks post-operatively (mean 13.4 weeks). No complications related to infection, iatrogenic radial nerve injury or implant failure were noted in the study. 4 cases had varus angulation deformity but did not affect shoulder or elbow function. CONCLUSIONS MIPO is a safe and effective technique for the management of diaphyseal humerus fractures, with early fracture healing, less risk of complications such as infection and iatrogenic radial nerve injury, along with a cosmetically acceptable scar. KEYWORDS Fracture Fixation, Fracture Healing, Humeral Fractures, Radial Nerve, Shoulder

scholarly journals Secondary Radial Nerve Palsy after Minimally Invasive Plate Osteosynthesis of a Distal Humeral Shaft Fracture

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Ursina Bichsel ◽  
Richard Walter Nyffeler
Keyword(s):  
Minimally Invasive ◽  
Radial Nerve ◽  
Nerve Palsy ◽  
Plate Osteosynthesis ◽  
Shaft Fracture ◽  
Humeral Shaft Fracture ◽  
Humeral Shaft ◽  
Radial Nerve Palsy ◽  
Minimally Invasive Plate Osteosynthesis ◽  
Short Time

Minimally invasive plate osteosynthesis is a widely used procedure for the treatment of fractures of the femur and the tibia. For a short time it is also used for the treatment of humeral shaft fractures. Among other advantages, the ambassadors of this technique emphasize the lower risk of nerve injuries when compared to open reduction and internal fixation. We report the case of secondary radial nerve palsy caused by percutaneous fixation of a plate above the antecubital fold. The nerve did not recover and the patient needed a tendon transfer to regain active extension of the fingers. This case points to the importance of adequate exposure of the bone and plate if a humeral shaft fracture extends far distally.

scholarly journals Comparison between minimally invasive plate osteosynthesis and open reduction–internal fixation for proximal humeral fractures: a meta-analysis based on 1050 individuals

2019 ◽  
Author(s):  
Feilong Li ◽  
Tao Nie ◽  
Xuqiang Liu ◽  
Fuqiang Wang ◽  
Zhiping Gu ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Internal Fixation ◽  
Nerve Injury ◽  
Open Reduction ◽  
Plate Osteosynthesis ◽  
Meta Analysis ◽  
Axillary Nerve ◽  
Open Reduction Internal Fixation ◽  
Humeral Fractures ◽  
Minimally Invasive Plate Osteosynthesis

Abstract Background This meta-analysis aimed to compare the clinical outcomes and complications of minimally invasive plate osteosynthesis (MIPO) and open reduction–internal fixation (ORIF) in patients with proximal humeral fractures. Methods We searched PubMed, EMBASE, Ovid, and the Cochrane Library to identify all relevant studies from inception to April 2019. Cochrane Collaboration’s Review Manage 5.3 was used for meta-analysis. Results Sixteen studies involving 1050 patients (464 patients in the MIPO group and 586 patients in the ORIF group) were finally included. According to the meta-analysis, MIPO was superior to ORIF in operation time, blood loss, postoperative pain, fracture union time, and constant score. However, MIPO was associated with more exposure to radiation and axillary nerve injury. No significant differences were found in length of hospital stays and complication except for axillary nerve injury. Conclusion The present evidence indicates that MIPO offers superior outcomes in comparison to ORIF. However, surgeons should pay attention to reducing radiation exposure and avoiding axillary nerve injury.

scholarly journals A New Minimally Invasive Approach for Treatment of Middle and Distal-third Humeral Shaft Fractures

2021 ◽  
Author(s):  
Jing Yang ◽  
Lina Zhang ◽  
Dapeng Liu ◽  
Zhanxin Lu ◽  
Tang Liu
Keyword(s):  
Minimally Invasive ◽  
Plate Osteosynthesis ◽  
Constant Score ◽  
Humeral Shaft ◽  
High Rate ◽  
Minimally Invasive Plate Osteosynthesis ◽  
Invasive Approach ◽  
Humeral Shaft Fractures ◽  
Shaft Fractures

Abstract Purpose: To evaluate the feasibility and safety of a new minimally-invasive surgical approach–anteromedial minimally-invasive plate osteosynthesis (MIPO) in the treatment of middle and distal-third segment humeral shaft fractures.Methods: From November 2016 to March 2020, 14 patients (8 males and 6 females) with middle and distal-third segment humeral shaft fracture who were treated surgically by one surgeon of our department were retrospectively evaluated. Four fractures were type A1, tow fractures type A2, four fractures type A3 and four fractures type B1. In the surgical procedure, 11 fractures were treated with anterolateral MIPO approach, while three fractures used the anterolateral + lateral MIPO approach. Patient’s age averaged 48 years (range, 25–81). Results: Average follow-up time, months: 21.7, (range 12 to 36 months). QuickDASH score at final follow-up averaged 2.5 points (range, 0–4.5), The constant score averaged 88.5 points (range, 80–100). All fractures there were no nerve injuries, infections, and Other severe complications occurred.Conclusion: The anteromedial approach MIPO technique has the advantages of less trauma, less bleeding, low risk of nerve injury and high rate of fracture healing. It is one of the most effective methods for the treatment of middle and middle–distal humeral shaft fractures. Our study provided a new approach for the treatment of middle and distal-third segment Humeral shaft fractures.

Sign in / Sign up

Export Citation Format

Share Document