Outcome of Minimally Invasive Plate Osteosynthesis for Comminuted Diaphyseal Humeral Fractures

Abstract

Aims: To examine the clinical outcomes of the minimally invasive plate osteosynthesis technique for comminuted diaphyseal humeral fractures based on clinical and radiologic records. Study Design:  Prospective study. Place and Duration of Study: This study was carried on twenty-one adult patients with comminuted humeral shaft fracture treated with MIPO between February 2020 to February 2021 were included in this study. Methods: Patients with pathological fracture, Gustilo and Anderson type 2 or 3, intra-articular fracture and preoperative radial nerve palsy were excluded. The surgery time, blood loss and time of union were noted. Clinical outcome was assessed by Q-DASH score. Results: We had thirteen cases of 12-B type and eight cases of 12-C type of fracture. According to Q-DASH score, eighteen cases had satisfactory results. The mean radiological fracture union time was 13.85 weeks. Mean elbow flexion was 1250, mean extension range was -2.140. out of all cases, two cases had superficial wound infection. One patient had iatrogenic radial nerve palsy. One patient had non-union. Conclusion: Although technically demanding, MIPO technically should be considered one of the management options in the treatment of complex humeral diaphyseal fractures as it adheres to biological fixation principles with minimal soft tissue dissection, preserving fracture hematoma and periosteal blood supply.