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Minimally Invasive Plate Osteosynthesis of Humeral Shaft Fractures: Current State of the Art.

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Affiliations

  • 1. From the Department of Orthopaedic Surgery, Royal Brisbane Hospital, Herston, Australia, and the Department of Surgery, School of Medicine, University of Queensland, Brisbane, Australia (Dr. Tetsworth); the Medical School, University of Queensland, Brisbane, Australia, the Faculty of Health, University of Pretoria, Pretoria, South Africa, and the Valiant Clinic/Houston Methodist Group, Dubai, United Arab Emirates (Dr. Hohmann); and the University of Texas Health Science Center, San Antonio, TX (Dr. Glatt).
      Authors
    • Tetsworth K 1
    (1 author)

ORCIDs linked to this article

The Journal of the American Academy of Orthopaedic Surgeons, 01 Sep 2018, 26(18):652-661
https://doi.org/10.5435/jaaos-d-17-00238 PMID: 30113346 

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Abstract 

Most closed humeral shaft fractures can be successfully managed nonsurgically. However, fractures for which closed treatment is unsuccessful are stabilized using either plates or intramedullary nails. There are shortcomings associated with each technique, including the potential complications of nonunion, infection, shoulder pain, and radial nerve injury. Minimally invasive plate osteosynthesis (MIPO), an innovative alternative treatment, is gaining in popularity. This technique is based on the anterior humeral shaft providing a relatively safe surface for plate application, and limited open exposures proximally and distally allow percutaneous insertion of the necessary implant. More than 40 articles have been published regarding MIPO, and it compares favorably to other available forms of treatment with excellent functional outcomes and a lower rate of iatrogenic radial nerve injury. Larger randomized controlled trials comparing this method with other accepted techniques, including nonsurgical management, are necessary to better define the role of MIPO in the management of humeral shaft fractures.

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Read article at publisher's site: https://doi.org/10.5435/jaaos-d-17-00238

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