Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2016

Open Access 01-12-2016 | Research article

Effects of different surgical techniques on mid-distal humeral shaft vascularity: open reduction and internal fixation versus minimally invasive plate osteosynthesis

Authors: Zichao Xue, Chaolai Jiang, Chuanzhen Hu, Hui Qin, Haoliang Ding, Zhiquan An

Published in: BMC Musculoskeletal Disorders | Issue 1/2016

Login to get access

Abstract

Background

Humeral shaft fractures are generally managed with the conventional posterior open reduction and internal fixation (ORIF) or minimally invasive plate osteosynthesis (MIPO). This study was aimed at comparing the outcomes of these surgical techniques in terms of the vascular integrity of the mid-distal humeral shaft.

Methods

Twelve upper limbs were harvested from 6 fresh cadavers. ORIF or MIPO was randomly performed on either side of each pair of limbs. The axillary artery was perfused with a latex-lead tetraoxide red solution to visualize the vascular structures. The vascular integrity of the humerus was examined by plain radiography and dissection. The periosteal filling achieved with each technique was scored and the scores compared.

Results

In each limb, one main nutrient artery entering the mid-distal humeral shaft anteromedially (83.3 %) or medially (16.7 %) was first identified. No case of injury to the main nutrient artery was noted for either surgical technique. Injuries to the accessory nutrient arteries entering the mid-distal humeral shaft from the posterior aspect were absent in the MIPO cases, but occurred in 52.9 % of the ORIF cases. In addition, MIPO was also superior to the open plate technique showed superior periosteal filling than.

Conclusions

Our results showed that the MIPO technique is superior to the ORIF in terms of preserving the vascular integrity of the mid-distal humeral shaft.
Literature
1.
Bhandari M, Devereaux PJ, McKee MD, Schemitsch EH. Compression plating versus intramedullary nailing of humeral shaft fractures--a meta-analysis. Acta Orthop. 2006;77(2):279–84.CrossRefPubMed
2.
Changulani M, Jain UK, Keswani T. Comparison of the use of the humerus intramedullary nail and dynamic compression plate for the management of diaphyseal fractures of the humerus. A randomised controlled study. Int Orthop. 2007;31(3):391–5.CrossRefPubMed
3.
Niall DM, O'Mahony J, McElwain JP. Plating of humeral shaft fractures--has the pendulum swung back? Injury. 2004;35(6):580–6.CrossRefPubMed
4.
Apivatthakakul T, Arpornchayanon O, Bavornratanavech S. Minimally invasive plate osteosynthesis (MIPO) of the humeral shaft fracture. Is it possible? A cadaveric study and preliminary report. Injury. 2005;36(4):530–8.CrossRefPubMed
5.
Livani B, Belangero WD. Bridging plate osteosynthesis of humeral shaft fractures. Injury. 2004;35(6):587–95.CrossRefPubMed
6.
Ma HR, Ma SL, Yin TZ. Coupled exofixator for comminuted fracture of humeral shaft. Chin J Traumatol. 2005;8(1):33–5.PubMed
7.
Yang KH. Helical plate fixation for treatment of comminuted fractures of the proximal and middle one-third of the humerus. Injury. 2005;36(1):75–80.CrossRefPubMed
8.
An Z, Zeng B, He X, Chen Q, Hu S. Plating osteosynthesis of mid-distal humeral shaft fractures: minimally invasive versus conventional open reduction technique. Int Orthop. 2010;34(1):131–5.CrossRefPubMed
9.
Farouk O, Krettek C, Miclau T, Schandelmaier P, Guy P, Tscherne H. Minimally invasive plate osteosynthesis and vascularity: preliminary results of a cadaver injection study. Injury. 1997;28 Suppl 1:A7–12.CrossRefPubMed
10.
Zhiquan A, Bingfang Z, Yeming W, Chi Z, Peiyan H. Minimally invasive plating osteosynthesis (MIPO) of middle and distal third humeral shaft fractures. J Orthop Trauma. 2007;21(9):628–33.CrossRefPubMed
11.
Anous MM. A clean technique for cadaver injection studies. Plast Reconstr Surg. 1988;82(1):199.PubMed
12.
13.
Kobayashi M, Watanabe Y, Matsushita T. Early full range of shoulder and elbow motion is possible after minimally invasive plate osteosynthesis for humeral shaft fractures. J Orthop Trauma. 2010;24(4):212–6.CrossRefPubMed
14.
Kontakis GM, Tosounidis T, Pagkalos J. Humeral diaphyseal aseptic non-unions: an Algorithm of management. Injury. 2007;38 Suppl 2:S39–49.CrossRefPubMed
15.
Nagel A. The clinical significance of the nutrient artery. Orthop Rev. 1993;22(5):557–61.PubMed
16.
Pidhorz L. Acute and chronic humeral shaft fractures in adults. Orthop Traumatol Surg Res. 2015;101(1 Suppl):S41–9.CrossRefPubMed
17.
Rhinelander FW. Tibial blood supply in relation to fracture healing. Clin Orthop Relat Res. 1974;105:34–81.CrossRef
18.
Wilson JW. Vascular supply to normal bone and healing fractures. Semin Vet Med Surg. 1991;6(1):26–38.
19.
Gainor BJ, Metzler M. Humeral shaft fracture with brachial artery injury. Clin Orthop Relat Res. 1986;204:154–61.
20.
Gardner MJ, Voos JE, Wanich T, Helfet DL, Lorich DG. Vascular implications of minimally invasive plating of proximal humerus fractures. J Orthop Trauma. 2006;20(9):602–7.CrossRefPubMed
Metadata
Title
Effects of different surgical techniques on mid-distal humeral shaft vascularity: open reduction and internal fixation versus minimally invasive plate osteosynthesis
Authors
Zichao Xue
Chaolai Jiang
Chuanzhen Hu
Hui Qin
Haoliang Ding
Zhiquan An
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2016
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-016-1224-3

Other articles of this Issue 1/2016

BMC Musculoskeletal Disorders 1/2016 Go to the issue

Research article

Back pain and health status in patients with clinically diagnosed ankylosing spondylitis, psoriatic arthritis and other spondyloarthritis: a cross-sectional population-based study

Research article

A large two-centre study in to rates of influenza and pneumococcal vaccination and infection burden in rheumatoid arthritis in the UK

Research article

Profiling microRNA expression during fracture healing

Debate

What have we learned from ten years of trajectory research in low back pain?

Research article

Paraspinal muscles density: a marker for degenerative lumbar spinal stenosis?

Research article

Minimal important improvement thresholds for the six-minute walk test in a knee arthroplasty cohort: triangulation of anchor- and distribution-based methods