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Original Article
- Minimal Invasive Plate Osteosynthesis versus Conventional Open Plating in Simple Humeral Shaft Fracture (AO Type A, B1, B2)
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Boseon Kim, M.D.
, GwangChul Lee, M.D., Hyunwoong Jang, M.D. -
Journal of the Korean Fracture Society 2017;30(3):124-130.
DOI: https://doi.org/10.12671/jkfs.2017.30.3.124
Published online: July 21, 2017
Department of Orthopaedic Surgery, Chosun University School of Medicine, Gwangju, Korea.
- Correspondence to: GwangChul Lee, M.D. Department of Orthopaedic Surgery, Chosun University Hospital, 365 Pilmundae-ro, Dong-gu, Gwangju 61453, Korea. Tel: +82-62-220-3147, Fax: +82-62-226-3379, leekci@chosun.ac.kr
• Received: March 7, 2017 • Revised: May 29, 2017 • Accepted: June 15, 2017
Copyright © 2017 The Korean Fracture Society. All rights reserved.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Abstract
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Purpose
- The purpose of this study is to evaluate the efficacy of minimally invasive plate osteosynthesis (MIPO) by comparing the results between open plating and MIPO conducted by simple humeral shaft fractures.
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Materials and Methods
- From September 2010 to February 2015, we evaluated humeral shaft fractures that 26 cases underwent MIPO and 41 cases underwent open plate fixation (OPEN). Operation time, amount of blood loss, and radiative exposure time were examined. Radiographically, bone union time and angulation were compared. At last, UCLA shoulder score and MEPI were used to compare the clinical results of shoulder and elbow and complications were examined.
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Results
- The average operation time 82±23 minutes in MIPO, 119±20 minutes in OPEN (p=0.007) and amount of bleeding 238±67 ml in MIPO, 303±48 ml in OPEN (p=0.003), radiation exposure time 201±85 seconds in MIPO, 20±5 seconds in OPEN (p=0.000) were statistically significant. Bone union time and angulations, clinical results were not statistically significant. In Complication, iatrogenic radial nerve paralysis occurred 2 cases, nonunion occurred 1 case in MIPO. Nonunion and soft tissue infection occurred 2 cases each in OPEN.
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Conclusion
- MIPO in simple humeral shaft fractures gave us radiologically and clinically satisfactory results, and may be useful by understanding the anatomical knowledge and using appropriate implants and skills.
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REFERENCES
Fig. 1
Incisional site design (A) with broad 5.0 LCP® and skin incision (B) for the minimally invasive plate osteosynthesis technique.
Fig. 2
Clinical photo (A) and C-arm image (B) of closed reduction using modified pointed reduction forceps.
Fig. 3
(A) Preoperative radiography of a 52-year-old male showing a right humeral fracture (AO/OTA type A3). (B) Postoperative radiography showing closed reduction and internal fixation with Metaphyseal Plate® using the minimally invasive plate osteosynthesis technique. There are two holes for reduction and compression using modified pointed reduction forceps (white arrows). (C) Radiography at three months after the operation showing radiologic union.
Table 1
![jkfs-30-124-i001.jpg]()
Patient Data of Humeral Fracture
Table 2
![jkfs-30-124-i002.jpg]()
Comparison of Results
Figure & Data
REFERENCES
Citations
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- Outcomes of Arthroscopic Assisted Reduction and Percutaneous Fixation for Tongue-Type Sanders Type II Calcaneal Fractures
Jae Woo Park, Chul Hyun Park
Journal of Korean Foot and Ankle Society.2017; 21(4): 144. CrossRef
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XML DownloadMinimal Invasive Plate Osteosynthesis versus Conventional Open Plating in Simple Humeral Shaft Fracture (AO Type A, B1, B2)
Fig. 1
Incisional site design (A) with broad 5.0 LCP® and skin incision (B) for the minimally invasive plate osteosynthesis technique.
Fig. 2
Clinical photo (A) and C-arm image (B) of closed reduction using modified pointed reduction forceps.
Fig. 3
(A) Preoperative radiography of a 52-year-old male showing a right humeral fracture (AO/OTA type A3). (B) Postoperative radiography showing closed reduction and internal fixation with Metaphyseal Plate® using the minimally invasive plate osteosynthesis technique. There are two holes for reduction and compression using modified pointed reduction forceps (white arrows). (C) Radiography at three months after the operation showing radiologic union.
Fig. 1
Fig. 2
Fig. 3
Minimal Invasive Plate Osteosynthesis versus Conventional Open Plating in Simple Humeral Shaft Fracture (AO Type A, B1, B2)
Patient Data of Humeral Fracture
| Variable | MIPO group | OPEN group |
|---|---|---|
| No. of patient | 26 | 41 |
| Mean age (yr) | 50.2±18 | 43.0±18 |
| Sex | ||
| Male | 13 | 21 |
| Female | 13 | 20 |
| AO classification | ||
| A1 | 2 (7.7) | 3 (7.3) |
| A2 | 5 (19.2) | 7 (17.1) |
| A3 | 7 (26.9) | 5 (12.2) |
| B1 | 1 (3.8) | 11 (26.8) |
| B2 | 11 (42.3) | 15 (36.6) |
Values are presented as number only, mean±standard deviation, or number (%). The sum of the percentages does not equal 100% because of rounding. MIPO: minimally invasive plate osteosynthesis, OPEN: open plate fixation.
Comparison of Results
| Variable | MIPO group | OPEN group | p-value |
|---|---|---|---|
| Operation time (min) | 82.0±23 | 119.0±20 | 0.007 |
| Bleeding (ml) | 238.0±67 | 303.0±48 | 0.003 |
| Exposure to radiation (s) | 201.0±85 | 20.0±5 | 0.000 |
| Bone union (wk) | 17.2±9.4 | 17.0±3.6 | 0.226 |
| Angulation (°) | |||
| Varus | 6.0±2.1 | 1.0±1.5 | 0.114 |
| Anterior | 2.0±2.5 | 0.0±0.7 | |
| UCLA shoulder score | 34.1±10.7 | 33.7±12.9 | 0.156 |
| MEPI | 97.8±12.7 | 96.0±17.7 | 0.694 |
Values are presented as mean±standard deviation. p-values <0.05 were considered significant. MIPO: minimally invasive plate osteosynthesis, OPEN: open plate fixation, UCLA: University of California Los Angeles, MEPI: Mayo Elbow Performance Index.
Table 1
Patient Data of Humeral Fracture
Values are presented as number only, mean±standard deviation, or number (%). The sum of the percentages does not equal 100% because of rounding. MIPO: minimally invasive plate osteosynthesis, OPEN: open plate fixation.
Table 2
Comparison of Results
Values are presented as mean±standard deviation. p-values <0.05 were considered significant. MIPO: minimally invasive plate osteosynthesis, OPEN: open plate fixation, UCLA: University of California Los Angeles, MEPI: Mayo Elbow Performance Index.
