Minimally invasive plate osteosynthesis of humeral shaft fractures with locking compression plate: short-term results in 17 cases / 中华创伤骨科杂志

ABSTRACT

Objective To evaluate minimally invasive plate osteosynthesis (MIPO) technique in the treatment of humeral shaft fractures using locking compression plate (LCP). Methods Between February 2004 and January 2005, 17 consecutive patients with 17 humeral shaft fractures were treated with LCP by MIPO technique. There were 12 men and 5 women with a mean age of 48 years (range, 18 to 75). According to AO classification, three fractures were type12-A, 10 type 12-B, and four type 12-C. Results The mean duration of follow-up was 19. 1 months (range 14 to 25) . Union occurred in all patients with a mean healing time of 11. 3 weeks (range 9 to 14) . With regard to ROM of the shoulder, the mean flexion was 174 degrees (range, 135 to 180 ), the mean extension was 38 degrees (range, 20 to 40), and the mean abduction was 87 degree (range, 70 to 90). For the elbow, the mean flexion was 133 degree (range, 115 to 135), the mean extension was -1 degree(range, - 10 to 0). Using the patient-rated functional questionnaire, the mean DASH (disabilities of the arm, shoulder and hand) score of 11 points (range, 6 to 44) at the latest follow-up indicated a mild to moderate impairment. There were three postoperative complications. One superficial infection occurred in a Custilo type MB open fracture and was uneventfully healed with conservative managements. One patient experienced transient radial nerve palsy which showed complete remission within 3 months. The third one demonstrated a dysfunction of shoulder and elbow. There were no cases of secondary malalignment or late hardware failure in this cohort. Conclusions Internal fixation using LCP in MIPO can attain a stable fixation, a high union rate as well as a low complication rate. The neurovascular structures may be at less risk of iatrogenic injuries through the anterior approach. It may be considered a reliable and efficient method for humeral shaft fractures, especially for comminuted ones and those with poor bone quality.