Minimally Invasive Plate Osteosynthesis for Humeral Proximal or Distal Shaft Fractures Using a 3.5/5.0 Metaphyseal Locking Plate

Hyoung Keun Oh; Suk Kyu Choo; Jung Il Lee; Dong Hyun Seo

doi:10.12671/jkfs.2012.25.4.305

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Oh, Choo, Lee, and Seo: Minimally Invasive Plate Osteosynthesis for Humeral Proximal or Distal Shaft Fractures Using a 3.5/5.0 Metaphyseal Locking Plate

Original Article

Journal of the Korean Fracture Society

Journal of the Korean Fracture Society 2012; 25(4): 305-309.

Published online: 19 October 2012

DOI: https://doi.org/10.12671/jkfs.2012.25.4.305

Minimally Invasive Plate Osteosynthesis for Humeral Proximal or Distal Shaft Fractures Using a 3.5/5.0 Metaphyseal Locking Plate

Hyoung Keun Oh, M.D., Suk Kyu Choo, M.D., Jung Il Lee, M.D., Dong Hyun Seo, M.D.

Department of Orthopedic Surgery, Inje University Ilsan Paik Hospital, Goyang, Korea.

Address reprint requests to: Hyoung Keun Oh, M.D. Department of Orthopedic Surgery, Inje University Ilsan Paik Hospital, 170, Juhwa-ro, Ilsanseo-gu, Goyang 411-706, Korea. Tel: 82-31-910-7968, Fax: 82-31-910-7967, osd11@paik.ac.kr

Received 5 July 2012 Revised 5 July 2012 Accepted 19 August 2012

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

Our study aimed to investigate the clinical and radiological results of humerus proximal or distal shaft fractures treated with minimally invasive plate osteosynthesis (MIPO) using a 3.5/5.0 metaphyseal locking plate.

Materials and Methods

We reviewed the clinical and radiographic records of 17 patients with humeral proximal or distal shaft fractures who had undergone 3.5/5.0 metaphyseal locking plate osteosynthesis with a minimally invasive technique. We evaluated the results with respect to the anatomical reduction and union of the humerus shaft fracture through radiologic studies. We also evaluated the clinical results using the motion of shoulder and elbow functional outcome, American Shoulder and Elbow Surgeons (ASES) score, Mayo elbow performance score (MEPS), and postoperative complications.

Results

Complete union was achieved in all cases. The mean union time was 14.2 weeks. According to the functional outcome rated by the ASES score and MEPS, 15 cases were considered excellent and 2 cases were good. There were no cases of surgically-related complications like metal failure, loss of anatomical reduction, or postoperative nerve injuries.

Conclusion

Using a 5.0 metaphyseal locking plate for humerus shaft fracture has the limitation that difficulties can arise in achieving sufficient screw fixation for small bony fragments. The 3.5/5.0 metaphyseal locking plate used in MIPO for humerus 1/3 proximal or distal shaft fractures was concluded to give good clinical and radiologic results.

Keywords: Humerus proximal or distal shaft fractures, Minimally invasive plate osteosynthesis, 3.5/5.0 metaphyseal locking plate

Figures and Tables

Fig. 1

(A) Case of distal humeral shaft fracture of a 21-year-old man. Preoperative radiographs show distal humeral shaft fracture with a butterfly fragment.

(B) Minimally invasive plate osteosynthesis using 3.5/5.0 locking compression plate was performed. The short distal fragment was fixed with five 3.5 mm screws.

(C) Last follow-up radiographs show solid bony union without screw loosening.

Fig. 2

(A) Case of proximal humeral shaft fracture of a 44-year-old woman. Preoperative radiographs show proximal humeral shaft fracture with a butterfly fragment.

(B) Minimally invasive plate osteosynthesis using 3.5/5.0 locking compression plate was performed. The short proximal fragment was fixed with five 3.5 mm screws.

(C) Last follow-up radiographs show solid bony union without screw loosening.

References

1. Ahn HS, Cho YH, Byun YS, Kwon DY, Nam SO, Kim DY. Elbow function and complications after internal fixation for fractures of the distal humerus. J Korean Fract Soc. 2006. 19:56–61.

2. Apivatthakakul T, Patiyasikan S, Luevitoonvechkit S. Danger zone for locking screw placement in minimally invasive plate osteosynthesis (MIPO) of humeral shaft fractures: a cadaveric study. Injury. 2010. 41:169–172.

3. Bono CM, Grossman MG, Hochwald N, Tornetta P 3rd. Radial and axillary nerves. Anatomic considerations for humeral fixation. Clin Orthop Relat Res. 2000. (373):259–264.

4. Chapman JR, Henley MB, Agel J, Benca PJ. Randomized prospective study of humeral shaft fracture fixation: intramedullary nails versus plates. J Orthop Trauma. 2000. 14:162–166.

5. Flinkkilä T, Hyvönen P, Lakovaara M, Linden T, Ristiniemi J, Hämäläinen M. Intramedullary nailing of humeral shaft fractures. A retrospective study of 126 cases. Acta Orthop Scand. 1999. 70:133–136.

6. Ha SS, Kim JY, Hong KD, Sim JC, Kang JH, Park KH. Operative treatment with locking compression plate (LCP) in proximal humerus fracture. J Korean Shoulder Elbow Soc. 2008. 11:137–142.

7. Kobayashi M, Watanabe Y, Matsushita T. Early full range of shoulder and elbow motion is possible after minimally invasive plate osteosynthesis for humeral shaft fractures. J Orthop Trauma. 2010. 24:212–216.

8. Lee HJ, Oh CW. Operative treatment of humerus shaft fracture: conventional open plating or minimally invasive plate osteosynthesis. J Korean Fract Soc. 2012. 25:155–162.

9. Livani B, Belangero WD. Bridging plate osteosynthesis of humeral shaft fractures. Injury. 2004. 35:587–595.

10. Michener LA, McClure PW, Sennett BJ. American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form, patient self-report section: reliability, validity, and responsiveness. J Shoulder Elbow Surg. 2002. 11:587–594.

11. Rommens PM, Blum J, Runkel M. Retrograde nailing of humeral shaft fractures. Clin Orthop Relat Res. 1998. (350):26–39.

12. Shin SJ, Do NH, Song MH, Sohn HS. Minimal invasive plate osteosynthesis in proximal humerus fractures. Clin Should Elbow. 2010. 13:202–208.

13. Shin SJ, Sohn HS, Do NH, Kang SS, Baek KY. Minimally invasive plate osteosynthesis of proximal, middle and distal humerus fractures. J Korean Orthop Assoc. 2010. 45:448–455.

14. Vander Griend R, Tomasin J, Ward EF. Open reduction and internal fixation of humeral shaft fractures. Results using AO plating techniques. J Bone Joint Surg Am. 1986. 68:430–433.

15. Zhiquan A, Bingfang Z, Yeming W, Chi Z, Peiyan H. Minimally invasive plating osteosynthesis (MIPO) of middle and distal third humeral shaft fractures. J Orthop Trauma. 2007. 21:628–633.

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