Minimally Invasive Plate Osteosynthesis (Mipo) in Humeral Shaft Fractures – Biomechanics – Design – Clinical Results

Sanjeevaiah, Sanjeevaiah; Reddy, Pera Jayavardhan

doi:10.14260/jemds/2015/1368

Cited by 4 publications

(5 citation statements)

References 17 publications

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“…Some clinical studies about minimally invasive anterior fixation of humeral shaft fracture have been reported. [ 24 25 26 27 28 ] Minimally invasive anterior fixation of humeral shaft fracture has its own advantages, for example, the minimally invasive plate osteosynthesis (MIPO) technique does offer a procedure with less stripping that can reduce the incidence of nonunion. A smaller incision, theoretically, causes less injury to the neurovascular structures.…”

Section: Discussionmentioning

confidence: 99%

“…A smaller incision, theoretically, causes less injury to the neurovascular structures. [ 24 25 26 27 28 ] The disadvantages are also obvious: Six disadvantages will be discussed. First, fracture reduction is difficult because it is a closed reduction.…”

Section: Discussionmentioning

confidence: 99%

“…Maintaining reduction is also very difficult. [ 24 25 ] There is the risk of injury to the radial nerve in the process of complex fracture reduction[ 26 28 ] and this may also increase the soft tissue injury around the fracture site. Second, during the operation, repeated C-arm X-ray monitoring was needed to monitor the position of the fracture and the placement of the plate and screw, and increases radiation hazard for medical staff and the patients.…”

Section: Discussionmentioning

confidence: 99%

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Biomechanical Study of the Fixation Strength of Anteromedial Plating for Humeral Shaft Fractures

Zheng

Zhou

Wang³

et al. 2016

Chinese Medical Journal

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Background:Open reduction and internal fixation with plate and screws are the gold standard for the surgical treatment of humeral shaft fractures, this study was to compare the mechanical properties of anteromedial, anterolateral, and posterior plating for humeral shaft fractures.Methods:A distal third humeral shaft fracture model was constructed using fourth-generation sawbones (#3404, composite bone). A total of 24 sawbones with a distal third humeral shaft fracture was randomly divided into three Groups: A, B, and C (n = 8 in each group) for anteromedial, anterolateral, and posterior plating, respectively. All sawbones were subjected to horizontal torsional fatigue tests, horizontal torsional and axial compressive fatigue tests, four-point bending fatigue tests in anteroposterior (AP) and mediolateral (ML) directions and horizontal torsional destructive tests.Results:In the horizontal torsional fatigue tests, the mean torsional angle amplitude in Groups A, B, and C were 6.12°, 6.53°, and 6.81°. In horizontal torsional and axial compressive fatigue tests, the mean torsional angle amplitude in Groups A, B, and C were 5.66°, 5.67°, and 6.36°. The mean plate displacement amplitude was 0.05 mm, 0.08 mm, and 0.10 mm. Group A was smaller than Group C (P < 0.05). In AP four-point bending fatigue tests, the mean plate displacement amplitude was 0.16 mm, 0.13 mm, and 0.20 mm. Group B was smaller than Group C (P < 0.05). In ML four-point bending fatigue tests, the mean plate displacement amplitude were 0.16 mm, 0.19 mm, and 0.17 mm. In horizontal torsional destructive tests, the mean torsional rigidity in Groups A, B, and C was 0.82, 0.75, and 0.76 N·m/deg. The yielding torsional angle was 24.50°, 25.70°, and 23.86°. The mean yielding torque was 18.46, 18.05, and 16.83 N·m, respectively.Conclusions:Anteromedial plating was superior to anterolateral or posterior plating in all mechanical tests except in AP four-point bending fatigue tests compared to the anterolateral plating group. We can suggest that anteromedial plating is a clinically safe and effective way for humeral shaft fractures.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Biomechanical Study of the Fixation Strength of Anteromedial Plating for Humeral Shaft Fractures

Zheng

Zhou

Wang³

et al. 2016

Chinese Medical Journal

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“…In the study by Sanjeevaiah et al the mean blood loss was 85 ml for the MIPO group. 24 In the study by Lu et al mean blood loss for the ORIF group was 278.33 ml. 23 In our study, minimum intraoperative blood loss was 120 ml and a maximum blood loss was 210 ml with a mean blood loss of 147 ml, which is an acceptable surgical blood loss and significantly lesser than the blood loss in COP.…”

Section: Discussionmentioning

confidence: 95%

Radiological and functional outcomes of anterior bridge plating with minimally invasive plate osteosynthesis technique for humerus diaphyseal fractures in adults

Dave,

Modi,

Pawar

et al. 2023

Int J Res Orthop

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Background: We conducted a study to evaluate radiological, functional outcomes and complications of internal fixation of humerus diaphyseal fractures by anterior bridge plating (ABP) with minimally invasive plate osteosynthesis technique. Methods: 40 patients with humerus diaphyseal fractures operated by ABP with MIPO between August 2017 and January 2020 were included in the study. All patients were evaluated verbally, clinically, and radiologically for a minimum of 1 year. Results: Mean time to radiological union was 13.75 weeks. Disabilities of the arm, shoulder and hand score improved from a mean of 23.45 to a mean of 5.04 at 6 months. All patients except one had an excellent Mayo Elbow Performance Score score at 6 months. The variation of mean shoulder range of motion between normal and operated side was within 5 degrees at 6 months. Visual Analogue Scale score improved from a preoperative mean of 8 to a postoperative mean of 0.5 at 6 months. Mean intraoperative blood loss was 147 ml. Two patients had a superficial wound infection, one patient had a postoperative radial nerve palsy, and one patient had a delayed union, all of which recovered without any surgical intervention. Conclusions: ABP with MIPO technique for humerus diaphyseal fractures is a safe and effective treatment modality yielding high rates of union, excellent functional recovery, minimal biological disruption, better cosmesis, and superior patient satisfaction. Therefore, we recommend that ABP with MIPO should be considered as an alternative treatment option in patients with humerus diaphyseal fractures.

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“…Surgical approach is that described by Livani et al [20] Acromion process was palpated and marked and 5 cm caudal to it a proximal incision of 2-3 cm between the medial border of deltoid and proximal biceps. Distally, around 5 cm proximal to the flexion crease, a 2-3 cm incision at the lateral border of the biceps was made (Fig 1) Functional evaluation was done by using UCLA [21] Shoulder rating score and Mayo elbow performance score (MEPS) [22]. Anteroposterior (AP) and the lateral radiograph were taken at each follow-up for assessing fracture union and position of the implant.…”

Section: Surgical Techniquementioning

confidence: 99%

Clinico-Radiological and Functional outome of anterior bridge plating with Minimally Invasive Plate Osteosynthesis (MIPO) in diaphyseal fracture humerus: A prospective study

Saraf¹,

Mahipal²,

Huda³

2020

J Bone Joint Dis

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The aim of our work is to assess the clinico-radiological and functional outcome in management of humerus diaphyseal fracture by anterior bridge plating with MIPO technique. Methods: 21 patients of traumatic diaphyseal fractures of humerus were managed by Anterior Bridge Plating using MIPO technique between 2017-2018 in a series conducted at our center. The side affected, gender ratio, surgery time, fracture union time and complication were noted. UCLA shoulder and Mayo elbow performance score were used. Results: The study population consisted of 11(52.4%) males and 10(47.6%) females. The mean age was 39.71±13.18 (Range = 18-65) years. Mean surgical time was 99.52 minutes. Road traffic injury was the most common mode. 1 case of infection 2 of non union and 3 cases of post op radial nerve palsy encountered and resolved accordingly. The mean UCLA shoulder and MEPS showed statistically significant improvement in functional outcome with time. Conclusion:There is statistically significant improvement in clinic-radiological and functional outcome with time. Anterior Bridge plating with MIPO technique is a good technique which respects the biological fixation principles and causes minimal soft tissue assault while preserving the fracture haematoma and maintains periosteal blood channels for management of humeral diaphyseal fractures.

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Minimally Invasive Plate Osteosynthesis (Mipo) in Humeral Shaft Fractures – Biomechanics – Design – Clinical Results

Cited by 4 publications

References 17 publications

Biomechanical Study of the Fixation Strength of Anteromedial Plating for Humeral Shaft Fractures

Biomechanical Study of the Fixation Strength of Anteromedial Plating for Humeral Shaft Fractures

Radiological and functional outcomes of anterior bridge plating with minimally invasive plate osteosynthesis technique for humerus diaphyseal fractures in adults

Clinico-Radiological and Functional outome of anterior bridge plating with Minimally Invasive Plate Osteosynthesis (MIPO) in diaphyseal fracture humerus: A prospective study

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