Top

European Journal of Orthopaedic Surgery & Traumatology

Published in:

01-07-2013 | Original Article

Internal fixation of humeral shaft fractures using minimally invasive plating: comparative study of two implants

Authors: Longxiang Shen, Hui Qin, Zhiquan An, Bingfang Zeng, Famin Yang

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 5/2013

Abstract

Purpose

We compared the results of two types of implants, dynamic compression plates (DCPs) and locking compression plates (LCPs), applied to correct mid-distal third humeral shaft fractures using minimally invasive plating osteosynthesis (MIPO).

Methods

Data of 43 patients with mid-distal third humeral shaft fractures treated using MIPO were retrospectively analyzed. Patients were divided into two groups according to the implants applied: group A (n = 26), those whose fractures were fixed with 4.5-mm DCP, and group B (n = 17) fixed with 4.5-mm LCP or metaphyseal LCP. The outcomes of the two groups in terms of operative time, time of fracture union, occurrence of early and late postoperative complications, University of California—Los Angeles (UCLA) End-Result score and the Mayo Elbow Performance Index (MEPI) were compared.

Results

The mean operative time was 107.8 ± 33.1 min in group A and 91.2 ± 40.4 min in group B (p > 0.05). The mean time of fracture union was 16.77 ± 6.01 weeks in group A and 14.59 ± 5.73 weeks in group B (p > 0.05). Seven (26.9 %) patients had postoperative complications in group A and 3 (17.6 %) in group B (p > 0.05). The mean UCLA End-Result score in group A was 34.31 ± 1.26 points and 33.12 ± 2.76 points in group B (p > 0.05). The mean MEPI was 100.00 ± 0.00 points in group A and 97.35 ± 7.52 points in group B (p > 0.05).

Conclusions

In surgical stabilization of mid-distal humeral shaft fractures using MIPO, application of DCP or LCP resulted in good outcomes, there were no significant differences between the outcomes of these two types of implant.

Kurup H, Hossain M, Andrew JG (2011) Dynamic compression plating versus locked intramedullary nailing for humeral shaft fractures in adults. Cochrane Database Syst Rev 6:CD005959. doi:10.1002/14651858.CD005959.pub2 PubMed

Apivatthakakul T, Arpornchayanon O, Bavornratanavech S (2005) Minimally invasive plate osteosynthesis (MIPO) of the humeral shaft fracture. Is it possible? A cadaveric study and preliminary report. Injury 36(4):530–538. doi:10.1016/j.injury.2004.05.036 PubMedCrossRef

Ziran BH, Belangero W, Livani B, Pesantez R (2007) Percutaneous plating of the humerus with locked plating: technique and case report. J Trauma 63(1):205–210. doi:10.1097/01.ta.0000231870.11908.3e PubMedCrossRef

An Z, Zeng B, He X, Chen Q, Hu S (2010) Plating osteosynthesis of mid-distal humeral shaft fractures: minimally invasive versus conventional open reduction technique. Int Orthop 34(1):131–135. doi:10.1007/s00264-009-0753-x PubMedCrossRef

Kobayashi M, Watanabe Y, Matsushita T (2010) Early full range of shoulder and elbow motion is possible after minimally invasive plate osteosynthesis for humeral shaft fractures. J Orthop Trauma 24(4):212–216. doi:10.1097/BOT.0b013e3181c2fe49 PubMedCrossRef

Ziran BH, Kinney RC, Smith WR, Peacher G (2010) Sub-muscular plating of the humerus: an emerging technique. Injury 41(10):1047–1052. doi:10.1016/j.injury.2010.04.021 PubMedCrossRef

Ring D, Kloen P, Kadzielski J, Helfet D, Jupiter JB (2004) Locking compression plates for osteoporotic nonunions of the diaphyseal humerus. Clin Orthop Relat Res 425:50–54PubMedCrossRef

Pospula W, Abu Noor T (2006) Percutaneous fixation of comminuted fractures of the humerus: initial experience at Al Razi hospital, Kuwait. Med Prince Pract 15(6):423–426. doi:10.1159/000095487 CrossRef

Numbela BX, Aceves LH, Gonzalez AB, Castro CT (2007) Minimally invasive surgery in diaphyseal humeral fractures with helicoidal plate. One year result in seven patients. Acta Orthop Mex 21(5):239–246

10.

Livani B, Belangero WD, Castro de Medeiros R (2006) Fractures of the distal third of the humerus with palsy of the radial nerve: management using minimally-invasive percutaneous plate osteosynthesis. J Bone Joint Surg Br 88(12):1625–1628. doi:10.1302/0301-620X.88B12.17924 PubMed

11.

Livani B, Belangero WD (2004) Bridging plate osteosynthesis of humeral shaft fractures. Injury 35(6):587–595. doi:10.1016/j.injury.2003.12.003 PubMedCrossRef

12.

Concha JM, Sandoval A, Streubel PN (2010) Minimally invasive plate osteosynthesis for humeral shaft fractures: are results reproducible? Int Orthop 34(8):1297–1305. doi:10.1007/s00264-009-0893-z PubMedCrossRef

13.

Shetty MS, Kumar MA, Sujay K, Kini AR, Kanthi KG (2011) Minimally invasive plate osteosynthesis for humerus diaphyseal fractures. Indian J Orthop 45(6):520–526. doi:10.4103/0019-5413.87123 PubMedCrossRef

14.

Oh CW, Byun YS, Oh JK, Kim JJ, Jeon IH, Lee JH, Park KH (2012) Plating of humeral shaft fractures: comparison of standard conventional plating versus minimally invasive plating. Orthop Traumatol Surg Res 98(1):54–60. doi:10.1016/j.otsr.2011.09.016 PubMedCrossRef

15.

(1996) Fracture and dislocation compendium. Orthopaedic trauma association committee for coding and classification. J Orthop Trauma 10(Suppl 1):v–ix, 1–154. http://www.ncbi.nlm.nih.gov/pubmed/8814583

16.

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. doi:10.1097/BOT.0b013e31815928c2 PubMedCrossRef

17.

Ellman H, Hanker G, Bayer M (1986) Repair of the rotator cuff. End-result study of factors influencing reconstruction. J Bone Joint Surg Am 68(8):1136–1144PubMed

18.

Ellman H (1987) Arthroscopic subacromial decompression: analysis of one- to three-year results. Arthroscopy 3(3):173–181PubMedCrossRef

19.

Gill DR, Morrey BF (1998) The Coonrad-Morrey total elbow arthroplasty in patients who have rheumatoid arthritis. A ten to fifteen-year follow-up study. J Bone Joint Surg Am 80(9):1327–1335PubMed

20.

Niall DM, O’Mahony J, McElwain JP (2004) Plating of humeral shaft fractures–has the pendulum swung back? Injury 35(6):580–586. doi:10.1016/j.injury.2003.10.021 PubMedCrossRef

21.

Paris H, Tropiano P, Clouet D’orval B, Chaudet H, Poitout DG (2000) Fractures of the shaft of the humerus: systematic plate fixation Anatomic and functional results in 156 cases and a review of the literature. Rev Chir Orthop Reparatrice Appar 86(4):346–359

22.

Jawa A, McCarty P, Doornberg J, Harris M, Ring D (2006) Extra-articular distal-third diaphyseal fractures of the humerus. A comparison of functional bracing and plate fixation. J Bone Joint Surg Am 88(11):2343–2347. doi:10.2106/JBJS.F.00334 PubMedCrossRef

23.

Gardner MJ, Griffith MH, Demetrakopoulos D, Brophy RH, Grose A, Helfet DL, Lorich DG (2006) Hybrid locked plating of osteoporotic fractures of the humerus. J Bone Joint Surg Am 88(9):1962–1967. doi:10.2106/JBJS.E.00893 PubMedCrossRef

24.

Snow M, Thompson G, Turner PG (2008) A mechanical comparison of the locking compression plate (LCP) and the low contact-dynamic compression plate (DCP) in an osteoporotic bone model. J Orthop Trauma 22(2):121–125. doi:10.1097/BOT.0b013e318160c84c PubMedCrossRef

25.

O’Toole RV, Andersen RC, Vesnovsky O, Alexander M, Topoleski LD, Nascone JW, Sciadini MF, Turen C, Eglseder WA Jr (2008) Are locking screws advantageous with plate fixation of humeral shaft fractures? A biomechanical analysis of synthetic and cadaveric bone. J Orthop Trauma 22(10):709–715. doi:10.1097/BOT.0b013e31818df8cb PubMedCrossRef

26.

Livani B, Belangero W, Andrade K, Zuiani G, Pratali R (2009) Is MIPO in humeral shaft fractures really safe? Postoperative ultrasonographic evaluation. Int Orthop 33(6):1719–1723. doi:10.1007/s00264-008-0616-x PubMedCrossRef

27.

Jiang R, Luo CF, Zeng BF, Mei GH (2007) Minimally invasive plating for complex humeral shaft fractures. Arch Orthop Trauma Surg 127(7):531–535. doi:10.1007/s00402-007-0313-z PubMedCrossRef

Title: Internal fixation of humeral shaft fractures using minimally invasive plating: comparative study of two implants
Authors: Longxiang Shen
Hui Qin
Zhiquan An
Bingfang Zeng
Famin Yang
Publication date: 01-07-2013
Publisher: Springer-Verlag
Published in: European Journal of Orthopaedic Surgery & Traumatology / Issue 5/2013
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-012-1039-3

At a glance: The STEP trials

Springer Medicine

Internal fixation of humeral shaft fractures using minimally invasive plating: comparative study of two implants

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 5/2013

Management of Vancouver type B2 and B3 femoral periprosthetic fractures using an uncemented extensively porous-coated long femoral stem prosthesis

Is there a stable vertebral height restoration with the new radiofrequency kyphoplasty? A clinical and radiological study

Dislocated intra-articular femoral head fracture associated with fracture-dislocation of the hip and acetabulum: report of 12 cases and technical notes on surgical intervention

Latissimus dorsi flap coverage of soft tissue defect following below-knee amputation: emphasis on flap design and recipient vessels

Traumatic and non-traumatic isolated horizontal meniscal tears of the knee in patients less than 40 years of age

Intramedullary nailing versus percutaneous locked plating of distal extra-articular tibial fractures: a retrospective study