Minimally invasive plate osteosynthesis using a locking compression plate for diaphyseal humeral fractures
Sachit Malhan1, Simon Thomas, Shekhar Srivastav
1Department of Orthopaedics, Delhi Institute of Trauma and Orthopaedics, Sant Parmanand Hospital, New Delhi, India.
Purpose:
To assess outcomes of minimally invasive plate osteosynthesis (MIPO) using a locking compression plate (LCP) for 42 humeral shaft fractures. METHODS. 28 men and 14 women aged 18 to 68 (mean, 34; median, 29) years underwent closed reduction and MIPO using a LCP for type 12-A (n=26) and type 12-B (n=16) humeral shaft fractures. Eight of the patients were aged ≥ 50 years. Patients were followed up monthly until radiological union in at least 3 of the 4 cortices. Functional assessment was based on the Disabilities of Arm, Shoulder and Hand (DASH) score.
Results:
The mean follow-up period was 25 (range, 14-35) months. The mean DASH score was 35.1 at month 3 and improved to 8.9 at month 6 and 5.2 at year 1. The mean angulation was 4º in the coronal plane and 7º in the sagittal plane. All fractures united after a mean of 14 weeks. Two patients with transverse fractures had delayed union and received bone marrow injections at 12 or 13 weeks; they achieved union at week 20. One patient developed a radial nerve palsy immediately after surgery and underwent surgical exploration through the anterolateral approach. The plate was re-applied, and the nerve recovered in 48 hours with full power in all the muscle groups.
Conclusion:
MIPO with LCP is a safe and effective technique for fixation of diaphyseal humeral fractures, and results in faster bone union, better cosmesis, and minimal complications.
