scholarly journals Midterm Results of Minimally Invasive Plating Osteosynthesis Versus Open Reduction and Internal Fixation for the Treatment of Mid-distal Humeral Shaft Fractures: A Case-match Controlled Comparison Study

2020 ◽  
Author(s):  
Bo Yin ◽  
Jie Gao ◽  
Huayong Zeng ◽  
Zheng Lu ◽  
Yanhong Cai ◽  
...  
Keyword(s):  
Major Complication ◽  
Shaft Fracture ◽  
Humeral Shaft Fracture ◽  
Humeral Shaft ◽  
Complication Rates ◽  
Comparison Study ◽  
Humeral Shaft Fractures ◽  
Shaft Fractures ◽  
Distal Shaft

Abstract Background: Surgical treatment of humeral mid-distal shaft fractures is controversial. The purpose of this case-match controlled comparison study was to determine the safety and effectiveness of applying the MIPO technique compared with conventional ORIF for treating humeral mid-distal shaft fractures.Methods: This study was conducted from January 2012 to December 2016, and patients of mid-distal humeral shaft fractures were eligible for this study. The patients were followed up for a minimum period of 1 year. The clinical and radiographic outcomes were evaluated. The inclusion criteria were age between 18 to 60 years and acute displaced mid-distal humeral shaft fracture. The exclusion criteria were intra-articular fractures of the elbow, vascular insufficiency of the upper limb, pathological fracture and multiple or open fractures. The medical records and radiographs of all eligible patients during hospitalization and follow-up after discharge were reviewed. We use a 1:2 (MIPO/ORIF) case-match based on gender and age. All patients had at least 3 years of postoperative follow-up.Results: In total, 216 patients with mid-distal humeral shaft fracture underwent surgery at the departments of orthopedics of the Seventh Medical Center of PLA General Hospital and Beijing Chaoyang Hospital. Of them, 28 underwent MIPO and 56 case-matched controls underwent ORIF; all of them had complete 3-year follow-up data. No significant differences were observed in baseline characteristics between both groups. UCLA scores and MEPS were significantly higher in the MIPO group than in the ORIF group. Furthermore, UCLA score and MEPS grades in the MIPO group were significantly superior to those in the ORIF group. There was no statistically significant difference in major complication rates between both groups; however, the total major complication rate was significantly different between both groups.Conclusion: This study demonstrates that MIPO has a statistically significant clinical benefit over ORIF, including better shoulder and elbow joint function, with few overall major complications after at least 3 years of postoperative follow-up. MIPO is a safe and effective method for treating mid-distal humeral shaft fractures when surgery is indicated.

HEALING PATTERN OF INTERLOCKED INTRAMEDULLARY NAILED HUMERAL SHAFT FRACTURE

2016 ◽  
Vol 19 (04) ◽  
pp. 1650018
Author(s):  
Myung-Sang Moon ◽  
Dong-Hyeon Kim ◽  
Min-Geun Yoon ◽  
Sang-Yup Lee
Keyword(s):  
Bone Fractures ◽  
Weight Bearing ◽  
Shaft Fracture ◽  
Humeral Shaft Fracture ◽  
Humeral Shaft ◽  
Long Bone ◽  
Patients Âgés ◽  
Humeral Shaft Fractures ◽  
Shaft Fractures ◽  
Entry Points

Design: Study on the cases of the united interlocked intramedullary (IM) nailed humeral shaft fractures. Objective: To assess the healing pattern of nailed humeral shaft fracture and to compare it with the results of the other previous authors’ nail-treated large bone fractures. Background data: Based on the relevant previous studies related with healing patterns of the interlocked IM nail-managed humeral shaft fractures, the current age-matched study on the participating callus for union was conceived. The comparative study on the healing patterns between the fractures of non-weight-bearing long bone — the humerus — and other large weight-bearing long bones have never been carried out previously. Materials and methods: Eighty-nine cases of the humeral shaft fractures, fixated with antegrade interlocked IM standard Kuentscher nail were subjected to the study. The patients’ ages ranged from the late teens to 9th decade of life. For the antegrade nailing, two entry points were chosen; conventional entry point in the early series, and rotator cuff interval in the late series. Results: External callus was very rarely formed [12 cases (13.4%)]. It was formed at post-fixation 6.5 weeks on average in cases with unreduced displaced fragment, and proximal interlocking. Radiographic union occurred at post-fixation 17.6 weeks on an average by primary osteonal callus. Conclusion: It was concluded that in most cases union was obtained primarily by the contact or gap healing irrespective of the patients’ ages, and that periosteal participation was very rare or negligible. Use of smaller diameter nail or new development of less rigid IM nail without external nail shape change is thought desirable to induce periosteal callus in early healing stage.

Surgical vs. Nonsurgical Management for Humeral Shaft Fractures; Preference Among Orthopaedic Surgeons

2021 ◽  
Vol 23 (1) ◽  
pp. 21-26
Author(s):  
Tariq A. Kwaees ◽  
Nasri H. Zreik ◽  
Charalambos P. Charalambous
Keyword(s):  
Shaft Fracture ◽  
Humeral Shaft Fracture ◽  
Humeral Shaft ◽  
Radial Nerve Palsy ◽  
Benefit Design ◽  
Electronic Survey ◽  
Humeral Shaft Fractures ◽  
Nonsurgical Management ◽  
Shaft Fractures ◽  
Diaphyseal Fractures

Background. Determining trends in managing humeral shaft fractures may help identify variation in practice which might benefit design of clinical guidance. We aimed to determine the practice of members of the British Elbow and Shoulder Society (BESS) in managing humeral shaft fractures. Methods and materials. An electronic survey was sent to members of BESS. Questions related to preferred surgical and nonsurgical approaches for management of humeral shaft fractures. This was divided into management of proximal, middle and distal third diaphyseal fractures. Results. 91 fully completed responses were analysed. Nonsurgical management was preferred by 90.1% (n=82) for middle-third and 80.2 % (n=73) for proximal third fractures but there was an almost even split in favouring surgical (52.7%, n=48) and nonsurgical (42.8%, n=39) treatment for distal third fractures. There was great variation in how to deal with a humeral shaft fracture associated with radial nerve palsy with an almost equal divide between those favouring a surgical and nonsurgical approach for mid-shaft or distal third fractures. Conclusions. 1. The management preference for humeral shaft fractures amongst surgeons is highly variable. 2. This may be partly attributed to the sparsity of high-quality evidence. 3. Well-designed randomised trials or pro­spective cohort studies may help further guide management of these injuries.

scholarly journals A Comparative Study on Internal Fixation Using Long Proximal Intramedullary Nail for the Treatment of Humeral Shaft Fracture according to Fracture Types

2019 ◽  
Vol 22 (2) ◽  
pp. 87-92
Author(s):  
Chang-Hyuk Choi ◽  
Chung-Mu Jun ◽  
Jun-Young Kim
Keyword(s):  
Internal Fixation ◽  
Shaft Fracture ◽  
Humeral Shaft Fracture ◽  
Optimal Choice ◽  
Humeral Shaft ◽  
Humeral Shaft Fractures ◽  
Shaft Fractures ◽  
Group I ◽  
The Mean ◽  
Group Ii

Background: This study was conducted to compare the radiological and clinical outcomes of internal fixation using a Polarus humeral nail for treatment of a humeral shaft fracture according to fracture types.Methods: From 43 patients, 13 were excluded and 30 patients were included. The 30 patients were divided into 2 groups: 15 in group I (Orthopaedic Trauma Association/Arbeitsgemeinschaft f?r Osteosynthesefragen classification type A and B) and 15 in group II (type C). The mean age was 63.1 years (range, 20?87 years), and mean follow-up period was 2.3 years (range, 1.0?6.1 years). The causes of injuries were as follows: 12, traffic accidents; 14, simple slips; 2, simple falls; 2, contusions after lower energy trauma. Radiological and clinical evaluations were performed.Results: Radiological union was confirmed by plain anteroposterior and lateral radiographs on average of 5.0 months in group I, and 8.4 months in group II, respectively. Differences between the two groups were statistically significant (<i>p</i><0.01). The clinical union value was 1.6 in group I, and 2.0 months in group II, but these values did not differ significantly (<i>p</i>=0.441). The mean Korean shoulder scoring system scores were 89.7 and 90.6, which did not differ significantly (<i>p</i>=0.352).Conclusions: Intramedullary nailing using the Polarus humeral nail is considered to be a good treatment modality for all types of humeral shaft fractures. Additionally, the Polarus humeral nail can be an optimal choice for the treatment of complex type fractures such as segmental or comminuted humeral shaft fractures.

scholarly journals HUMERAL SHAFT FRACTURES

2018 ◽  
Vol 25 (12) ◽  
pp. 1809-1813
Author(s):  
Junaid Khan ◽  
Raja Umar Liaqat ◽  
Muhammad Imran Aftab ◽  
Talia Urooj ◽  
Rahman Rasool Akhtar ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Dynamic Compression ◽  
Operative Management ◽  
Shaft Fracture ◽  
Humeral Shaft Fracture ◽  
Humeral Shaft ◽  
Trauma Patients ◽  
Humeral Shaft Fractures ◽  
Shaft Fractures ◽  
Dominant Condition

Objectives: To determine the functional outcome of operative management of humeral shaft fractures. Study Design: Prospective cohort study. Place and Duration: At the Department of Orthopaedics, Benazir Bhutto Hospital, Rawalpindi, for a duration of 02 years from 12th January 2016 to 11th January 2018. Patients and Methods: 45 patients presenting with humeral shaft fractures and meeting the inclusion criteria were included. All patients underwent fixation with a Dynamic Compression Plate (DCP). Functional outcome assessed at six months post-operatively using the American Shoulder and Elbow Surgeons Scoring System (ASES). Results: Mean age of patients included in the study was 34.6 ± 10.3 years.Out of the 45 patients, 31 (68.9%) were males and 14 (31.1%) females. Pre-dominant condition resulting in operative management was humeral shaft fracture in poly trauma patients (n=27, 60%). Shoulder functioning following surgery was good with a mean ASES score of 81.1±10.6. Conclusion: Plating in humeral shaft fractures results in a good functional outcome postoperatively. 

scholarly journals Application of Ultrasonography in Conservative Treatment of Humeral Shaft Fracture in Children

2021 ◽  
Author(s):  
Jun Li ◽  
Xin Tan ◽  
Xiang Li ◽  
Pan Gou ◽  
Xiaowei Yuan ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Nerve Injury ◽  
Shaft Fracture ◽  
Humeral Shaft Fracture ◽  
Humeral Shaft ◽  
Dash Score ◽  
X Ray ◽  
Epidemic Period ◽  
Significant Difference

Abstract Purpose: Most of humeral shaft fractures in children could be treated satisfactorily by conservative treatment. This study aimed to evaluate the application value of ultrasonography in conservative treatment of humeral shaft fracture in children.Methods: We retrospectively reviewed children admitted to our hospital, for humeral shaft fracture from January 2014 to March 2018. The patients were divided into two groups: ultrasonography group and X-ray group. All patients were instructed to re-examined at 1 week, 2 weeks, 4 weeks, 12 weeks, 24 weeks and 1 year from the injury date for follow-up, and evaluated the prognosis according to the Disabilities of Arm, Shoulder and Hand (DASH) score at 12 months.Results: A total of 37 children were divided into ultrasonography group, 32 children were divided into X-ray group. There was no significant difference in prognosis between the two groups. The mean number of radiation exposures of ultrasonography group was less and ultrasonic examination found radial nerve injury, and using ultrasound reduced the chance of direct or in direct contact with infected peoples.Conclusion: Ultrasound is a non-invasive, non-radioactive test, which could decrease risk of COVID-19 infection and detect the vascular nerve injury caused by fracture. Ultrasonography may be the examination method for follow-up conservative treatment of humeral shaft fracture in children during the epidemic period.

scholarly journals The modified anterolateral approach to the humerus

2019 ◽  
Vol 27 (3) ◽  
pp. 230949901986595
Author(s):  
Angela Christine Chang ◽  
Ngoc Buu Ha ◽  
Christopher Sagar ◽  
Gregory Ian Bain ◽  
Domenic Thomas Leonello
Keyword(s):  
Plate Osteosynthesis ◽  
Shaft Fracture ◽  
Humeral Shaft Fracture ◽  
Humeral Shaft ◽  
Muscle Fibres ◽  
Anterolateral Approach ◽  
Non Union ◽  
Small Series ◽  
Brachialis Muscle

Introduction: The anterior and anterolateral approaches to the humerus describe splitting brachialis longitudinally, assuming its fibres run parallel to the shaft. Recent improvements in the understanding of brachialis anatomy however have demonstrated it has two distinct heads, with the bulk of its fibres running oblique relative to the humerus. Attempting to split brachialis longitudinally to the extent required for plate osteosynthesis invariably leads to transection of a significant number of muscle fibres. The authors present a less muscle destructive modification to the anterolateral approach (ALA) based on a bicipital brachialis muscle. Method: In order to preserve brachialis muscle fibres, the modified ALA elevates the superficial head from the underlying humerus and longitudinally splits the deep head to allow a fixation device to be tunnelled. Case notes of patients with a humeral shaft fracture fixed via the modified ALA were retrospectively reviewed. Results: Ninteen humeral shaft fractures were fixed via the modified ALA. No post-operative nerve palsies were reported. Of the 19 patients, 14 (73.7%) received clinical and radiological follow-up. All reported being satisfied with their outcome. One developed a superficial wound infection and one (previous diagnosis of spondyloepiphyseal dysplasia tarda) developed a non-union requiring revision surgery. Of the five patients lost to follow-up, two died, and three reported no ongoing orthopaedic issues via telephone. Conclusions: Improved anatomical understanding of brachialis has resulted in the described modification to the ALA which is less muscle destructive and follows a truer inter-nervous plane. This small series demonstrates satisfactory outcomes using this approach.

scholarly journals Locked Intramedullary Nailing versus Dynamic Compression Plating for Humeral Shaft Fractures

2009 ◽  
Vol 17 (2) ◽  
pp. 139-141 ◽  
Author(s):  
Amit B Putti ◽  
Rajendra B Uppin ◽  
Babu B Putti
Keyword(s):  
Intramedullary Nailing ◽  
Functional Outcomes ◽  
Dynamic Compression ◽  
Adhesive Capsulitis ◽  
Humeral Shaft ◽  
Complication Rates ◽  
Humeral Shaft Fractures ◽  
Shaft Fractures ◽  
Compression Plating ◽  
Dynamic Compression Plating

Purpose. To compare functional outcomes, union and complication rates in patients treated with locked intramedullary nailing or dynamic compression plating for humeral shaft fractures. Methods. 32 men and 2 women with humeral shaft fractures were randomised to undergo locked antegrade intramedullary nailing (IMN, n=16) or dynamic compression plating (DCP, n=18). Patients with pathological fractures, grade-III open fractures, neurovascular injury, or fractures for more than 2 weeks were excluded. Fractures were classified according to the AO classification system (one in A1, 6 in A2, 12 in A3, 6 in B1, and 9 in B2). 28 were injured in road traffic accidents. The functional outcome (according to the American Shoulder and Elbow Surgeons [ASES] score) and rates of union and complication of the 2 groups were compared. Results. All patients were followed up for a minimum of 24 months. In the respective IMN and DCP groups, the mean ASES scores were 45.2 and 45.1 (p=0.69), the complication rates were 50% and 17% (p=0.038), and the non-union rates were 0% and 6% (p=0.15). In the IMN group, 2 sustained iatrogenic fractures during nail insertion; 2 had transient radial nerve palsies; one underwent nail removal for shoulder impingement; and 3 had adhesive capsulitis. In the DCP group, one underwent re-operation for implant failure; one had a superficial infection; and one developed adhesive capsulitis. Conclusion. The complication rate was higher in the IMN group, whereas functional outcomes were good with both modalities.

scholarly journals Comparative study of functional outcome of dynamic compression plating and interlocking intramedullary nailing for fructure shaft of humerus

2017 ◽  
Vol 3 (5) ◽  
pp. 1038
Author(s):  
Aminul Islam Mamood ◽  
Ajay Kumar Mahto
Keyword(s):  
Comparative Study ◽  
Dynamic Compression ◽  
Humeral Shaft ◽  
High Rate ◽  
Trauma Patients ◽  
Humeral Shaft Fractures ◽  
Shaft Fractures ◽  
One Year ◽  
Compression Plating

<p class="abstract"><strong>Background:</strong> Fracture of the diaphysis of humerus and its complications are a major cause of morbidity in trauma patients. Fracture of the humeral shaft account for 20% of humeral fractures &amp; about 3% of all fractures. There is a debate between the choices of operation in humeral shaft fractures.</p><p class="abstract"><strong>Methods:</strong> A comparative study of management of acute humeral shaft fractures treated by Dynamic Compression Plate (DCP) and Intra Medullary Interlocking Nail (IMILN) fixation over a period of one half years. 18 patients of IMILN and 20 patients of DCP were included after considering inclusion and exclusion criteria. Functional scoring criteria were used for postoperative assessment &amp; the average follow up period was one year.<strong></strong></p><p class="abstract"><strong>Results:</strong> A high rate of excellent &amp; good results &amp; a tendency for early union was seen with the plating group than nailing group.</p><strong>Conclusions:</strong> Plating shows better results than nailing.

Sign in / Sign up

Export Citation Format

Share Document