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Year : 2015  |  Volume : 28  |  Issue : 1  |  Page : 154-161

Minimally invasive plate osteosynthesis versus open reduction and plate fixation of humeral shaft fractures

Department of Orthopedic Surgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt

Correspondence Address:
Mahmoud Mohamed Hadhoud
Department of Orthopedic Surgery, Faculty of Medicine, Menoufia University, Sabery Abo-Allam Street, Shebin Al-Kom, Menoufia
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1110-2098.155974

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Objective This study compared clinical outcomes and complications in patients with humeral shaft fractures treated using two methods of fixation by means of plating. Background Plate osteosynthesis has been the treatment of choice for humeral shaft fractures when operative treatment is required. However, plate osteosynthesis of comminuted humeral fractures is a challenging operation, which requires surgical experience and meticulous attention to soft tissue. Minimally invasive plate osteosynthesis (MIPO) is an emerging procedure for the treatment of humeral shaft fractures. It preserves soft tissue and the periosteal circulation, which promotes fracture healing. Patients and methods Thirty patients were analyzed and divided into two groups. Group 1 (n = 15) patients were treated with MIPO and group 2 (n = 15) with open reduction and internal fixation (ORIF). The major characteristics of the two groups in terms of age, sex, mode of injury, fracture location, and associated injuries were similar. Results Primary union was achieved in all patients in the MIPO group and in 14 of 15 in the ORIF group. The mean time to union was similar in the two groups. The mean operation time in the MIPO group (80 min) was shorter than that in the ORIF group (125 min) (P < 0.0001). Bone grafting was performed in one patient in the ORIF group, but in no patients in the MIPO group. There was one case of deep infection in the ORIF group. There was one case of postoperative radial nerve palsy in the MIPO group and two cases in the ORIF group. Functional outcome was satisfactory in both groups. Conclusion The MIPO technique achieves comparable results with the ORIF method in simple and complex fractures of humeral shafts. Although MIPO potentially has a radiation hazard, it reduces perioperative complications with shortened operation time and minimal soft tissue dissection.

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