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Plating osteosynthesis of mid-distal humeral shaft fractures: minimally invasive versus conventional open reduction technique

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Abstract

Results of two methods, conventional open reduction–internal plating and minimally invasive plating osteosynthesis (MIPO), in the treatment of mid-distal humeral shaft fractures were compared. Thirty-three patients were retrospectively analysed and divided into two groups. Group A (n = 17) patients were treated by MIPO and group B (n = 16) by conventional plating. The mean operation time in group A was 92.35 ± 57.68 minutes and 103.12 ± 31.08 minutes in group B (P = 0.513). Iatrogenic radial nerve palsy in group A was 0% (0/17) and 31.3% in group B (5/16 (P = 0.012). The mean fracture union time in group A was 15.29 ± 4.01 weeks (range 8–24 weeks), and 21.25 ± 13.67 weeks (range 10–58 weeks) in group B (P = 0.095). The mean UCLA end-result score in group A was 34.76 ± 0.56 points (range 33–35), and 34.38 ± 1.41 points (range 30–35) in group B (P = 0.299). The mean MEPI in group A was 99.41 ± 2.43 points (range 90–100) and 99.69 ± 1.25 points (range 95–100) in group B ( P = 0.687). When compared to the conventional plating techniques, MIPO offers advantages in terms of reduced incidence of iatrogenic radial nerve palsies and accelerated fracture union and a similar functional outcome with respect to shoulder and elbow function.

Résumé

Les résultats de deux méthodes d’ostéosynthèse par plaques après réduction sanglante conventionnelle voie mini-invasive (MIPO) dans le traitement des fractures médio-diaphysaires de l’humérus ont été comparées. 33 patients ont été revus rétrospectivement et analysés et divisés en deux groupes : le groupe A (n = 17), traité par MIPO et le groupe B (n = 16) traité de façon conventionnelle. Le temps opératoire moyen dans le groupe A était de 92,35 +/−57,68 minutes et 103,12+/−31,08 minutes dans le groupe B (P = 0,513). Il n’a pas été observé de paralysies iatrogéniques du nerf radial dans le groupe A, par contre, dans le groupe B sont survenues 31,3% de paralysies 5/16 (p = 0,012). Le temps moyen de consolidation dans le groupe A a été de 15,29+/−4,01 semaines (8 à 24 semaines) et, dans le groupe B, de 21,25+/−13,67 semaines (10 à 58 semaines) (P = 0,095). Le score final UCLA dans le groupe A était de 34,76+/−0,56 points (33 à 35 points) et dans le groupe B de 34,38+/−1,41 points (30 à 35) (P = 0,299). Le MEPI moyen dans le groupe A a été de 99,41+/−2,43 points (de 90 à 100) et dans le groupe B de 99,69+/−1,25 points (95 à 100) (P = 0,687). Si l’on compare les deux techniques, la technique par voie mini-invasive (MIPO) permet de réduire la fréquence des paralysies du nerf radial, permet une consolidation plus rapide et une fonction similaire notamment au niveau de l’épaule et du coude.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Shanghai Sixth People’s Hospital, Shanghai Jiaotong University, Shanghai, China

    Zhiquan An, Bingfang Zeng, Xiaojian He & Qi Chen

  2. Department of Radiology, Shanghai Sixth People’s Hospital, Shanghai Jiaotong University, Shanghai, China

    Shundong Hu

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  1. Zhiquan An
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  2. Bingfang Zeng
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Correspondence to Zhiquan An.

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An, Z., Zeng, B., He, X. et al. Plating osteosynthesis of mid-distal humeral shaft fractures: minimally invasive versus conventional open reduction technique. International Orthopaedics (SICOT) 34, 131–135 (2010). https://doi.org/10.1007/s00264-009-0753-x

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