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.
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Sometimes serious tension occurs in the radial nerve when doing internal fixation for distal humerus shaft fracture or neurorrhaphy for radial nerve injury. Medial transposition of radial nerve on fracture site can avoid direct radial nerve injury by fracture fragment, radial nerve tension by plating for distal humerus shaft fracture, and also safe from neural tension during neurorrhaphy of damaged radial nerve. We reported here total 6 cases of backward transposition of radial nerve including 2 cases of radial nerve injury associated with humerus fracture and 4 cases of comminuted fracture of humerus shaft.
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