Treatment of Humerus Diaphyseal Fractures with Minimally Invasive Plate Osteosynthesis - Abstract
Introduction: Humerus fractures remain to be in the spectrum of multiple treatments. With the evolution of surgical care, newer methods of treating humerus fractures are coming to light, most important being minimally invasive plate osteosynthesis (MIPO). MIPO has discreet advantages with regards to minimal dissection, preservation of fracture biology and rotator cuff, and providing stability with elasticity to the bone plate construct. It is evident that biological fixation is superior to mechanical fixation, which forms the basis of MIPO.
The aim of our study was to evaluate the functional and radiological outcome of MIPO.
Materials and methods: 33 cases were studied over 2 years. Closed and open fractures, polytrauma patients, unstable fractures were included in the study. Pathological fractures, non-unions and malunions, refracture, and patients presenting after a delay of 21 days were excluded. 8 cases were aided by external fixators. Patients were followed up with UCLA and MEPS scores.
Results: 100 % union was seen in our series with an average union time of 10.94 ± 2.4 weeks. Majority of the cases had excellent UCLA shoulder score and MEP scores. The 3 cases of post traumatic radial nerve palsy recovered after surgery. Mean angulations of 6.09° was seen postoperatively. Infection was seen in 2cases which resolved later.
Conclusion: MIPO brings out a balance in fracture stability and biology preservation. It is thus a very novel and successful way of treating humerus with careful patient selection and mastering the art of this surgery.