Early Results of Bridge Plating of Humerus Diaphyseal Fractures by MIPO Technique.

BACKGROUND

Anterior bridge plating with minimally invasive technique in humeral shaft fractures is reported as an acceptable, less traumatic and reproducible procedure by several authors. We have evaluated the clini-cal, radiological, and functional outcome of such fractures in eleven patients, all of which were managed with dynamic compression plates over an average follow-up period of 22 months.

MATERIAL AND METHODS

Forty patients with humerus shaft fractures managed by anterior bridge plating using the MIPO technique between 2014 and 2016 were included in this series. All cases were treated with closed reduction and 10-12 hole 4.5mm dynamic compression plate fixation over anterolateral aspect in bridging mode using the MIPO technique. The UCLA shoulder and Mayo elbow performance scores were used for assessing shoulder and elbow function.

RESULTS

Of the forty patients followed up for a minimum of 18 months in the study, 26 were males and 14 were females. The mean age was 34.3 years (range 20 to 53 years). 24 out of the forty patients (60%) had the dominant side fractured. The mean surgical time was 72.5 minutes (range: 45-100 minutes) and mean radiation exposure was 160 seconds (range: 100-220 seconds). The mean radiological fracture union time was 13 weeks (range: 8-18 weeks). Shoulder function based on the UCLA score was excellent to good in 33 cases (82.5%), fair in 6 cases (15%) and one patient (2.5%) developed infection for which the plate was removed prematurely at the 4th month and the wound was meticulously debrided and then managed conservatively. Road traffic accident (RTA) was the most common mode of injury, found in 27 cases; 12 patients sustained blunt trauma due to a fall; one patient sustained an injury following a direct blow by stick.

CONCLUSIONS

1. The mini-incision anterior bridge technique for humeral shaft fractures gives good functional results and should be considered an effective, cosmetically advanced surgical option in the treatment of humeral shaft fractures. 2. The mini-incision anterior bridge technique is a safe and less method for simple types of humeral shaft fractures when the surgeon is experienced in the technique.