Treatment of humeral shaft fractures: a new minimally-invasive plate osteosynthesis versus open reduction and internal fixation: a case control study

Abstract Background 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 humeral shaft fractures. Methods Fourteen patients with humeral shaft fracture treated with anteromedial MIPO from November 2016 to March 2020 (MIPO Group) were selected as the study subjects. Open reduction and internal fixation (ORIF) were used to treat 14 patients with humeral shaft fractures as the control group (ORIF group). The two groups were fixed with a locking compression plate (LCP) or LCP + multi-directional locking screw system (MDLS). The incision length, intraoperative blood loss, intraoperative fluoroscopy time, operation time, length of hospital stay, fracture healing time, QuickDASH score and Constant score were observed and compared between the two groups. Results Fourteen patients were enrolled in each group. The incision length (7.79 ± 2.39 cm), intraoperative blood loss (96.07 ± 14.96 mL), operative time (110.57 ± 21.90 min), hospital stay (6.29 ± 1.49 days) and fracture healing time (14.94 ± 0.99 weeks) in the MIPO group were all lower than those in the ORIF group, and the difference was statistically significant for each parameter (P < 0.05). The intraoperative fluoroscopy time (20.07 ± 3.22) in the MIPO group was significantly higher than that in the ORIF group (P < 0.05). There were no significant differences in age (P = 0.078), QuickDASH score (P = 0.074) or Constant score (P = 0.293) between the two groups and no postoperative complications occurred in any of the patients. 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.

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

10.21203/rs.3.rs-555692/v1 ◽

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.

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