Minimally Invasive Plate Osteosynthesis of Humeral Shaft Fractures

Shin, Sang-Jin; Sohn, Hong Gyoo; Do, Nam-Hoon

doi:10.1097/bot.0b013e318254895f

Cited by 49 publications

(19 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Though increased risk of radial nerve injury is one of the issues with ABP, our study had no such an event. As described in multiple cadaveric studies, an important thing is to keep in mind the course of radial nerve near the distal end of the plate, which usually lies a few centimeters distal to the point where the nerve pierces the lateral intermuscular septum 7812181920). Sliding of the plate in a wrong fashion, careless drilling for the distal screws, or over-zealous retraction can lead to potentially catastrophic damage.…”

Section: Discussionmentioning

confidence: 99%

“…During insertion of the distal screws on the anterior surface (Fig. 1), care was taken to the proximity of the radial nerve laterally and brachial artery and musculocutaneous nerve medially 1217181920). Simple cortical screws were used in all cases (two proximally and two distally) except when the bone was extremely osteoporotic where locking screws were used (Fig.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Is Anterior Bridge Plating for Mid-Shaft Humeral Fractures a Suitable Option for Patients Predominantly Involved in Overhead Activities? A Functional Outcome Study in Athletes and Manual Laborers

Mahajan

Kim

et al. 2016

Clin Orthop Surg

View full text Add to dashboard Cite

BackgroundTo assess the functional and radiological outcomes of minimally invasive anterior bridge plating (ABP) for mid-shaft humerus fractures in patients predominantly involved in overhead activities (athletes and manual laborers).MethodsForty-eight patients fulfilling inclusion criteria were treated with ABP at a level-I trauma center using a 4.5-mm dynamic/locking compression plate and followed for a period of 1 year. Functional outcome was assessed using the Constant, Mayo elbow, and Disabilities of the Arm, Shoulder and Hand (DASH) scores. Range of motion (ROM), subjective strength, and radiographic union were assessed. A general satisfaction questionnaire was also administered.ResultsMost patients achieved excellent functional and radiological outcomes. ROM and strength of the shoulder girdle exhibited clinically nonsignificant loss as compared to the opposite side. The mean time for return to the original activities was 64 days (range, 36 to 182 days) and the mean time for confirmed radiographic union was 45 days (range, 34 to 180 days). The mean Constant, Mayo elbow, DASH scores were 95.73 ± 5.76 (range, 79 to 100), 95.94 ± 6.74 (range, 85 to 100), and 1.56 ± 3.15 (range, 0.0 to 14.0), respectively. The majority of patients (43 patients, 89.6%) who fell in the excellent or very good category according to our questionnaire were extremely satisfied. There were 2 cases (4.17%) of nonunion and 3 patients (6.25%) had to change/modify their original occupation.ConclusionsABP is fundamentally different from traditional open posterior plating or conventional intramedullary nailing. It gives relative stability with union taking place by callus formation, and a longer plate on the tensile surface ensures that the humerus can withstand greater amount of rotational and bending stresses. The minimally invasive nature causes minimal soft tissue damage and, if done correctly, causes no damage to the vital structures in proximity. ABP for mid-shaft humerus fractures in patients predominantly engaged in overhead activities is a safe and effective treatment modality yielding high rates of union, excellent functional recovery, minimal biological disruption, better cosmesis, and superior satisfaction rates.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Is Anterior Bridge Plating for Mid-Shaft Humeral Fractures a Suitable Option for Patients Predominantly Involved in Overhead Activities? A Functional Outcome Study in Athletes and Manual Laborers

Mahajan

Kim

et al. 2016

Clin Orthop Surg

View full text Add to dashboard Cite

show abstract

“…[6, 7] Recently, the minimally invasive percutaneous osteosynthesis (MIPO) technique has been advocated to treat humeral shaft fractures. [8, 9] This technique minimizes the disruption of the fracture site and limits soft-tissue stripping compared with conventional open reduction and internal fixation. [4, 10]…”

Section: Introductionmentioning

confidence: 99%

Surgical interventions to treat humerus shaft fractures: A network meta-analysis of randomized controlled trials

et al. 2017

View full text Add to dashboard Cite

BackgroundThere are three main surgical techniques to treat humeral shaft fractures: open reduction and plate fixation (ORPF), intramedullary nail (IMN) fixation, and minimally invasive percutaneous osteosynthesis (MIPO). We performed a network meta-analysis to compare three surgical procedures, including ORPF, IMN fixation, and MIPO, to provide the optimum treatment for humerus shaft fractures.MethodsMEDLINE, EMBASE, Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, and Cochrane library were researched for reports published up to May 2016. We only included randomized controlled trials (RCTs) comparing two or more of the three surgical procedures, including the ORPF, IMN, and MIPO techniques, for humeral shaft fractures in adults. The methodological quality was evaluated based on the Cochrane risk of bias tool. We used WinBUGS1.4 to conduct this Bayesian network meta-analysis. We used the odd ratios (ORs) with 95% confidence intervals (CIs) to calculate the dichotomous outcomes and analyzed the percentages of the surface under the cumulative ranking curve.ResultsSeventeen eligible publications reporting 16 RCTs were included in this study. Eight hundred and thirty-two participants were randomized to receive one of three surgical procedures. The results showed that shoulder impingement occurred more commonly in the IMN group than with either ORPF (OR, 0.13; 95% CI, 0.03–0.37) or MIPO fixation (OR, 0.08; 95% CI, 0.00–0.69). Iatrogenic radial nerve injury occurred more commonly in the ORPF group than in the MIPO group (OR, 11.09; 95% CI, 1.80–124.20). There were no significant differences among the three procedures in nonunion, delayed union, and infection.ConclusionCompared with IMN and ORPF, MIPO technique is the preferred treatment method for humeral shaft fractures.

show abstract

“…[12] Several published studies have compared MIPO with CPO in the treatment of humeral shaft fracture. [13–17] Up to now, the potential benefit of MIPO has not yet been confirmed in the previous studies.…”

Section: Introductionmentioning

confidence: 99%

Comparison of minimally invasive plate osteosynthesis and conventional plate osteosynthesis for humeral shaft fracture

Liu

Gao

et al. 2016

Medicine

View full text Add to dashboard Cite

Background:The objective of this meta-analysis was to compare the efficacy and safety of minimally invasive plate osteosynthesis (MIPO) and conventional plate osteosynthesis (CPO) for humeral shaft fracture.Methods:Potential academic articles were identified from the Cochrane Library, Medline (1966–2016.3), PubMed (1966–2016.3), Embase (1980–2016.3), and ScienceDirect (1966–2016.3). Gray studies were identified from the references of the included literature. Randomized controlled trials (RCTs) and non-RCT involving MIPO and CPO for humeral shaft fracture were included. Two independent reviewers performed independent data abstraction. I2 statistic was used to assess heterogeneity. Fixed or random effects model was used for meta-analysis.Results:Two RCTs and 3 non-RCTs met the inclusion criteria. There was a lower incidence of iatrogenic radial nerve palsy in patients with MIPO (P = 0.006). There was no statistically significant difference in in the risk of developing nonunion, delay union, malformation, screw loosening, infection, operation time, UCLA, and MEPS function score between the 2 groups.Conclusion:MIPO decreased incidence of iatrogenic radial nerve palsy and is an efficacy and safety technique for humeral shaft fracture. Due to the limited quality and data of the evidence currently available, more high-quality RCTs are required.

show abstract

Minimally Invasive Plate Osteosynthesis of Humeral Shaft Fractures

Cited by 49 publications

References 15 publications

Is Anterior Bridge Plating for Mid-Shaft Humeral Fractures a Suitable Option for Patients Predominantly Involved in Overhead Activities? A Functional Outcome Study in Athletes and Manual Laborers

Is Anterior Bridge Plating for Mid-Shaft Humeral Fractures a Suitable Option for Patients Predominantly Involved in Overhead Activities? A Functional Outcome Study in Athletes and Manual Laborers

Surgical interventions to treat humerus shaft fractures: A network meta-analysis of randomized controlled trials

Comparison of minimally invasive plate osteosynthesis and conventional plate osteosynthesis for humeral shaft fracture

Contact Info

Product

Resources

About