Skip to main content

Minimally invasive percutaneous plate osteosynthesis (MIPPO) technique applied in the treatment of humeral shaft distal fractures through a lateral approach


The minimally invasive percutaneous plate osteosynthesis (MIPPO) technique through the anterior approach has been successfully used in the treatment of humeral shaft fractures and has gained satisfactory clinical outcome. An anatomical study and a preliminary clinic report were performed to evaluate the feasibility of applying the MIPPO technique in the treatment of humeral shaft distal fractures through the lateral approach. This study was done on 14 arms from seven fresh cadavers. The results of this study showed that it is possible to treat humeral shaft distal fractures by using the MIPPO technique through the lateral approach. The results of using the MIPPO technique through the lateral approach in the treatment of humeral shaft fractures in 22 patients were also reviewed.


L’ostéosynthèse par plaques par voie mini-invasive (technique MIPPO), après abord antérieur est utilisée avec succès dans le traitement des fractures diaphysaires humérales et permet d’obtenir un bon résultat clinique. Une étude anatomique et une étude clinique préliminaires ont été réalisées pour évaluer la faisabilité de l’utilisation de la technique MIPPO dans le traitement de ces fractures distales par voie latérale. Cette étude a été réalisée sur 14 membres supérieurs de 7 cadavres frais. Les résultats de cette étude montrent qu’il est possible de traiter la fracture de l’humérus distal en utilisant la technique MIPPO par voie latérale. Cette technique, transposée chez 22 patients présentant une fracture de ce type a également été réalisée et évaluée.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3
Fig. 4


  1. Apivatthakakul T, Arpornchayanon O (2005) Minimally invasive plate osteosynthesis (MIPO) combined with distraction osteogenesis in the treatment of bone defects. A new technique of bone transport: a report of two cases. Injury 36(4):530–538

    PubMed  Article  CAS  Google Scholar 

  2. Fernandez Dell Oca AA (2002) The principle of helical implants. Unusual ideas worth considering. Injury Suppl 33:19–27

    Google Scholar 

  3. Frigg R (2001) Locking compression plate (LCP): an osteosynthesis plate based on the dynamic compression plate and point contact fixator (PCFix). Injury 32(Suppl 2):636

    Google Scholar 

  4. Frigg R (2003) Development of the locking compression plate. Injury 34(Suppl 2):B6–B10

    PubMed  Article  Google Scholar 

  5. Gerwin M, Hotchkiss RN, Weiland AJ (1996) Alternative operative exposures of the posterior aspect of the humeral diaphysis with reference to the radial nerve. J Bone Joint Surg Am 78-A:1690–1695

    Google Scholar 

  6. Heim D, Herkert F, Hess P, Regazzni P (1993) Surgical treatment of humeral shaft fracture: the Basel experience. J Trauma 35:22632

    Article  Google Scholar 

  7. Heitemeyer U, Kemper F, Hierholzer G, Haines J (1987) Severely comminuted femoral shaft fracture: treatment by bridging plate osteosynthesis. Arch Orthop Trauma Surg 106:327–330

    PubMed  Article  CAS  Google Scholar 

  8. Helfet DL, Shonnard PY, Levine D, Borrelli J Jr(1997) Minimally invasive plate osteosynthesis of distal fractures of the tibia. Injury 28(Suppl 1):428

    Google Scholar 

  9. Henle MB (1993) Humeral shaft fracture. In: Hansen ST, Swiontkowski MF (eds) Orthopedic trauma protocols. Raven Press, New York, pp 91–95

    Google Scholar 

  10. Ji Fang, Yang Tie-yi, Wang Ming-chun et al (2005) Anatomic analysis of MIPPO technique in treatment of humeral fractures: a preliminary clinic report. Chinese J Orthop Trauma 7(12):1128–1131

    Google Scholar 

  11. Lau TW, Leung F, Chan CF, Chow SP (2007) Minimally invasive plate osteosynthesis in the treatment of proximal humeral fracture. Int Orthop 31(5):657–664

    PubMed  Article  CAS  Google Scholar 

  12. Perren SM (2002) The technology of minimally invasive percutaneous osteosynthesis (MIPO). Injury 33(Suppl 1):VI–VII

    PubMed  Article  Google Scholar 

  13. Perren SM (2002) Evolution of the internal fixation of long bone fractures. The scientific basis of biological internal fixation: choosing a new balance between stability and biology. J Bone Joint Surg Br 84(8):1093–1110

    PubMed  Article  Google Scholar 

  14. Stoffel K, Dieter U, Stachowiak G, Gachter A, Kuster MS (2003) Biomechanical testing of the LCP-how can stability in locked internal fixators be controlled? Injury 34(Suppl 2):B11–B19

    PubMed  Article  Google Scholar 

  15. Wagner M (2003) General principles for the clinical use of the LCP. Injury 34(Suppl 2):B31–B42

    PubMed  Article  Google Scholar 

  16. Wagner M, Frenk A, Frigg R (2004) New concepts for bone fracture treatment and the locking compression plate. Surg Technol Int 12:271–277

    PubMed  Google Scholar 

  17. Zhiquan A, Bingfang Z, Yeming W, Chi Z, Peiyan H (2007) Minimally invasive plating osteosynthesis (MIPO) of middle and distal third humeral shaft fractures. J Orthop Trauma 21(9):628–633

    PubMed  Article  Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Dake Tong.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Ji, F., Tong, D., Tang, H. et al. Minimally invasive percutaneous plate osteosynthesis (MIPPO) technique applied in the treatment of humeral shaft distal fractures through a lateral approach. International Orthopaedics (SICOT) 33, 543–547 (2009).

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:


  • Radial Nerve
  • Humeral Shaft
  • Humeral Shaft Fracture
  • Musculocutaneous Nerve
  • Anterior Face