Evaluation of Patients Undergoing Fixation of Diaphyseal Humeral Fractures Using the Minimally Invasive Bridge-Plate Technique

Abstract

Objective: The aim was to describe the experience of our group in treating humeral shaft fractures using the bridge–plate technique via an anterior approach. Methods: Seventeen patients with acute diaphyseal humeral fractures with an indication for surgical treatment who were operated in 2006–2010 were evaluated. The AO and Gustilo & Anderson classifications were used. All the patients were operated using the anterior bridge-plate technique and completed a follow–up period of at least twelve months. Results: Sixteen men and one woman were treated. Their mean age was 31.8 years (18–52). Among the injury mechanisms found were: five motorcycle accidents, four car accidents, three fractures due to firearm projectiles, two falls to the ground and finally, with one case each, assault, crushing and being run over. Eight patients had open fractures: two grade I, one grade II, four grade IIIa and one grade IIIb, according to the Gustilo-Anderson classification. In relation to the AO classification, we found: one 12A1, three 12A2, four 12A3, one 12B1, four 12 B2, three 12B3 and one 12C2. The mean postoperative follow-up was 25 months (12–48). As complications, two patients had pain in the elbow and a ROM deficit and one had deep infection. The mean time taken to achieve consolidation was 17.5 weeks. There was no loss of reduction, pseudarthrosis or malunion in this series of patients. Conclusion: The authors believe that the technique described has low rates of complications and morbidity, with good initial results, although the series is limited by the small sample.

Técnica de Livani-Belangero (MIPO) en el tratamiento de las fracturas diafisarias de húmero. Experiencia latinoamericana en tres centros hospitalarios

“…Los métodos quirúrgicos convencionales para resolver las fracturas diafisarias de húmero no están exentos de complicaciones durante el procedimiento y después de este. 1 La mayoría de estas complicaciones se relacionan con la técnica y otras, con los riesgos de la exposición quirúrgica. 2 Por otro lado, existe un interés creciente en publicaciones sobre osteosíntesis con placa mínimamente invasiva (minimally invasive plate osteosynthesis, MIPO) en fracturas de húmero, con el fin de reducir las complicaciones y mejorar la tasa de consolidación.…”

Prevalence and risk factors for pseudarthrosis in humeral shaft fractures treated by minimally invasive plate osteosynthesis: A 10-year review

“…Fractures of the humeral shaft account for 3% to 5% of all fractures, and show a bimodal distribution, with a higher prevalence seen between the second and third decades, and after the sixth decade, of life. 1 Most humeral shaft fractures are treated conservatively. 2 Surgical treatment of humeral shaft fractures can be divided into 'absolute' and 'relative' types.…”

“…2 Surgical treatment of humeral shaft fractures can be divided into 'absolute' and 'relative' types. 1 The absolute type, involving the use of a dynamic compression plate (DCP), was the method of choice for many decades. Minimally invasive plate osteosynthesis (MIPO) is another viable treatment option, providing relatively good stability with biological preservation of bone; as such, this technique has been widely adopted.…”

“…Minimally invasive plate osteosynthesis (MIPO) is another viable treatment option, providing relatively good stability with biological preservation of bone; as such, this technique has been widely adopted. 1 Even with surgical treatment of humeral shaft fractures, non-union may still occur. 3 According to the Arbeitsgemeinschaft für Osteosynthesefragen (AO) group, non-union is defined as persistent fracture without consolidation requiring surgical intervention after the initial treatment.…”

“…Fractures of the humeral shaft account for 3% to 5% of all fractures, and show a bimodal distribution, with a higher prevalence seen between the second and third decades, and after the sixth decade, of life. 1…”