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 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2019

Open Access 01-12-2019 | Nerve Injury | Research article

Comparison between minimally invasive plate osteosynthesis and open reduction-internal fixation for proximal humeral fractures: a meta-analysis based on 1050 individuals

Authors: Feilong Li, Xuqiang Liu, Fuqiang Wang, Zhiping Gu, Qianyuan Tao, Cong Yao, Xuwen Luo, Tao Nie

Published in: BMC Musculoskeletal Disorders | Issue 1/2019

Login to get access

Abstract

Background

This meta-analysis aimed to compare the clinical outcomes and complications of minimally invasive plate osteosynthesis (MIPO) and open reduction–internal fixation (ORIF) in patients with proximal humeral fractures.

Methods

We searched PubMed, EMBASE, Ovid, and the Cochrane Library to identify all relevant studies from inception to April 2019. Cochrane Collaboration’s Review Manage 5.3 was used for meta-analysis.

Results

Sixteen studies involving 1050 patients (464 patients in the MIPO group and 586 patients in the ORIF group) were finally included. According to the meta-analysis, MIPO was superior to ORIF in operation time, blood loss, postoperative pain, fracture union time, and constant score. However, MIPO was associated with more exposure to radiation and axillary nerve injury. No significant differences were found in length of hospital stays and complication except for axillary nerve injury.

Conclusion

The present evidence indicates that compared to ORIF, MIPO had advantages in functional outcomes, operation time, blood loss, postoperative pain, and fracture union time for the treatment of PHFs. However, the MIPO technique had a higher rate of axillary nerve injury and longer radiation time compared to ORIF.
Appendix
Available only for authorised users
Literature
1.
Calvo E, Morcillo D, Foruria AM, Redondo-Santamaría E, Osorio-Picorne F, Caeiro JR, et al. Nondisplaced proximal humeral fractures: high incidence among outpatient-treated osteoporotic fractures and severe impact on upper extremity function and patient subjective health perception. J Shoulder Elbow Surg. 2011;20:795–801.CrossRef
2.
Horak J, Nilsson BE. Epidemiology of fracture of the upper end of the humerus. Clin Orthop Relat Res. 1975;112:250–3.CrossRef
3.
Kannus P, Palvanen M, Niemi S, Parkkari J, Järvinen M, Vuori I. Osteoporotic fractures of the proximal humerus in elderly Finnish persons: sharp increase in 1970-1998 and alarming projections for the new millennium. Acta Orthop Scand. 2000;71:465–70.CrossRef
4.
Gaebler C, McQueen MM, Court-Brown CM. Minimally displaced proximal humeral fractures: epidemiology and outcome in 507 cases. Acta Orthop Scand. 2003;74:580–5.CrossRef
5.
Pinkas D, Wanich TS, DePalma AA, Gruson KI. Management of malunion of the proximal humerus: current concepts. J Am Acad Orthop Surg. 2014;22:491–502.CrossRef
6.
Maier D, Jaeger M, Izadpanah K, Strohm PC, Suedkamp NP. Proximal humeral fracture treatment in adults. J Bone Joint Surg Am. 2014;96:251–61.CrossRef
7.
Hirschmann MT, Fallegger B, Amsler F, Regazzoni P, Gross T. Clinical longer-term results after internal fixation of proximal humerus fractures with a locking compression plate (PHILOS). J Orthop Trauma. 2011;25:286–93.CrossRef
8.
Brunner F, Sommer C, Bahrs C, Heuwinkel R, Hafner C, Rillmann P, et al. Open reduction and internal fixation of proximal humerus fractures using a proximal humeral locked plate: a prospective multicenter analysis. J Orthop Trauma. 2009;23:163–72.CrossRef
9.
Sohn HS, Jeon YS, Lee J, Shin SJ. Clinical comparison between open plating and minimally invasive plate osteosynthesis for displaced proximal humeral fractures: a prospective randomized controlled trial. Injury. 2017;48:1175–82.CrossRef
10.
Liu K, Liu P-c, Liu R, Wu X. Advantage of minimally invasive lateral approach relative to conventional deltopectoral approach for treatment of proximal humerus fractures. Med Sci Monit. 2015;21:496–504.CrossRef
11.
Acklin YP, Sommer C. Plate fixation of proximal humerus fractures using the minimally invasive anterolateral delta split approach. Oper Orthop Traumatol. 2012;24:61–73.CrossRef
12.
Zang JC, Du JJ, Li C, Wang JB, Ma XL. Comparison between minimally invasive plate osteosynthesis and open plating for proximal humeral fractures: a meta-analysis. J Comp Eff Res. 2018;7:1001–8.CrossRef
13.
Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009;339:b2535.CrossRef
14.
Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J. Methodological index for non-randomized studies (minors): development and validation of a new instrument. ANZ J Surg. 2003;73:712–6.CrossRef
15.
Liu BC, Yang ZW, Zhou F, Ji HQ, Zhang ZS, Guo Y, et al. Application of the modified internal fixation method of minimally invasive percutaneous plate osteosynthesis in treatment of proximal humeral fracture. Beijing Da Xue Xue Bao. 2019;51:277–82.PubMed
16.
Gao YB, Tong SL, Yu JH, Lu WJ. Case control study on open reduction internal fixation (ORIF) and minimally invasive percutaneous plate osteosynthesis (MIPPO) for the treatment of proximal humerus fractures in aged. Zhongguo Gu Shang. 2015;28:335–9.PubMed
17.
Liu J, Li SH, Li ZH, Wang JG, Yang CX, Zhang L, et al. Case-control study on minimally invasive percutaneous new plate osteosynthesis applied in proximal humerus fractures in elder patients. Zhongguo Gu Shang. 2013;26:4–8.PubMed
18.
Wang JF, Song HB, Gu HJ, Ling ZD, Ma HH. Case-control study on minimally invasive plate osteosynthesis for the treatment of proximal humeurs fractures in elderly patients. Zhongguo Gu Shang. 2012;25:487–9.PubMed
19.
Shang LP, Zhou F, Ji HQ, Zhang ZS, Liu XG, Tian Y. Comparison of curative effects between minimally invasive locking plate internal fixation and open reduction with internal fixation for the treatment of proximal humerus fractures. Beijing Da Xue Xue Bao. 2013;45:711–6.PubMed
20.
Fischer C, Frank M, Kunz P, Tanner M, Weber MA, Moghaddam A. Dynamic contrast-enhanced ultrasound (CEUS) after open and minimally invasive locked plating of proximal humerus fractures. Injury. 2016;47:1725–31.CrossRef
21.
Chiewchantanakit S, Tangsripong P. Locking plate fixation of proximal humeral fracture: minimally invasive vs. standard delto-pectoral approach. J Med Assoc Thai. 2015;98:196–200.PubMed
22.
Lin T, Xiao B, Ma X, Fu D, Yang S. Minimally invasive plate osteosynthesis with a locking compression plate is superior to open reduction and internal fixation in the management of the proximal humerus fractures. BMC Musculoskelet Disord. 2014;15:206.CrossRef
23.
Shen QF, Wen X, Yang SW, Chen X, Fan WX, Xu GZ, et al. MIPPO and ORIF for the treatment of elderly proximal humerus fractures of type Neer II:a case control study. Zhongguo Gu Shang. 2018;31:160–4.PubMed
24.
Zhang Z, Zhang G, Peng Y, Wang X, Guo H, Zhang W, et al. Modified minimally invasive approach and intra-osseous portal for three-part proximal humeral fractures: a comparative study. J Orthop Surg Res. 2018;13:24.CrossRef
25.
Liu YW, Wei XE, Kuang Y, Zheng YX, Gu XF, Zhan HS, et al. Open vs. closed reduction combined with minimally invasive plate osteosynthesis in humeral fractures. Minim Invasive Ther Allied Technol. 2016;25:215–21.CrossRef
26.
Röderer G, Erhardt J, Kuster M, Vegt P, Bahrs C, Kinz L, et al. Second generation locked plating of proximal humerus fractures--a prospective multicentre observational study. Int Orthop. 2011;35:425–32.CrossRef
27.
Zhao L, Yang P, Zhu L, Chen AM. Minimal invasive percutaneous plate osteosynthesis (MIPPO) through deltoid-pectoralis approach for the treatment of elderly proximal humeral fractures. BMC Musculoskelet Disord. 2017;18:187.CrossRef
28.
Kim YG, Park KH, Kim JW, Oh JK, Yoon JP, Kim HJ, et al. Is minimally invasive plate osteosynthesis superior to open plating for fixation of two-part fracture of the proximal humerus? J Orthop Surg (Hong Kong). 2019;27:2309499019836156.
29.
Gonç U, Atabek M, Teker K, Tanrıöver A. Minimally invasive plate osteosynthesis with PHILOS plate for proximal humerus fractures. Acta Orthop Traumatol Turc. 2017;51:17–22.CrossRef
30.
Acklin YP, Jenni R, Walliser M, Sommer C. Minimal invasive PHILOS®- plate osteosynthesis in proximal humeral fractures. Eur J Trauma Emerg S. 2009;35:35–9.CrossRef
31.
Koljonen PA, Fang C, Lau TW, Leung F, Cheung NWK. Minimally invasive plate osteosynthesis for proximal humeral fractures. J Orthop Surg (Hong Kong). 2015;23:160–3.CrossRef
32.
Ruchholtz S, Hauk C, Lewan U, Franz D, Kühne C, Zettl R. Minimally invasive polyaxial locking plate fixation of proximal humeral fractures: a prospective study. J Trauma. 2011;71:1737–44.PubMed
33.
Laflamme GY, Rouleau DM, Berry GK, Beaumont PH, Reindl R, Harvey EJ. Percutaneous humeral plating of fractures of the proximal humerus: results of a prospective multicenter clinical trial. J Orthop Trauma. 2008;22:153–8.CrossRef
34.
Metadata
Title
Comparison between minimally invasive plate osteosynthesis and open reduction-internal fixation for proximal humeral fractures: a meta-analysis based on 1050 individuals
Authors
Feilong Li
Xuqiang Liu
Fuqiang Wang
Zhiping Gu
Qianyuan Tao
Cong Yao
Xuwen Luo
Tao Nie
Publication date
01-12-2019
Publisher
BioMed Central
Keyword
Nerve Injury
Published in
BMC Musculoskeletal Disorders / Issue 1/2019
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-019-2936-y

Other articles of this Issue 1/2019

BMC Musculoskeletal Disorders 1/2019 Go to the issue

Study protocol

Development and evaluation of a tailored e-self-management intervention (dr. Bart app) for knee and/or hip osteoarthritis: study protocol

Research article

The expression of P16 and S100 associated with elastin degradation and fibrosis of the Ligamentum Flavum hypertrophy

Case report

Kyphoscoliosis with Klippel-Trenaunay syndrome: a case report and literature review

Research article

Analysis of sagittal alignment parameters following anterior cervical hybrid decompression and fusion of multilevel cervical Spondylotic myelopathy

Research article

Transfer of plantar pressure from the medial to the central forefoot in patients with hallux valgus

Research article

A comparison of lumbar transverse pedicle angles between ethnic groups: a retrospective review