Minimally invasive plate osteosynthesis (MIPO) for humeral diaphyseal fractures
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Published:
Jun 2, 2013
Keywords:
Locked intramedullary nailing, Fractures, Tibia
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Abstract
ObjectivesTo show and analyze the treatment of a group of humeral diaphyseal fractures with the minimally invasive plate osteosynthesis (MiPO) technique. Special emphasis was placed in analyzing immediate postoperative pain; delay to return to basic daily activities; time to radiological healing; and complications.MethodsFifteen humeral diaphyseal fractures were assessed retrospectively. The average age was 57 years (18-84). The average follow-up was 26 months (12-96). Eight cases were treated with anterior MiPO technique using straight implants. Seven cases were treated with MiPO technique using helical implants.ResultsHealing was reached in all cases. The average time to radiological healing was 12 weeks (6-32). Excluding one case with delayed union, the average time was 10 weeks (6-16). The average pain score according to the visual analogue scale for the first 48 hours after surgery was 2.4 (1-4). The average time needed to return to basic daily activities was 9 days (4-17). Complications included delayed union (1 case), superficial infection (1 case) and tenosynovitis of the long head of the biceps (1 case). Conclusions: The MiPO technique proved to be a method with a high healing rate requiring the same time or less compared to other osteosynthesis methods. It caused mild immediate postoperative pain and return to basic daily activities was quick. Complications were managed successfully.Key words: Fracture. Humerus. MIPO. Minimally invasive osteosynthesis.Level of evidence: IV
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How to Cite
Rupenian, P. R. (2013). Minimally invasive plate osteosynthesis (MIPO) for humeral diaphyseal fractures. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 78(2), 53-63. https://doi.org/10.15417/202
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Clinical Research
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References
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Masson; 2003:221-30.
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Informe de un caso y descripción de la técnica. Rev Asoc Argent Ortop Traumatol 2005;70(2):132-4.
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diafisarias del húmero con compromiso del tercio proximal. Rev Asoc Argent Ortop Traumatol 2005;70(3):252-5.
11. Perren SM. Evolution of the internal fixation of long bone fractures. J Bone Joint Surg Br 2002;84:1093-110.
12. Law TW, Leung F, Chan CF, Chow SP. Minimally invasive plate osteosynthesis in the treatment of proximal humeral fracture. Int Orthop 2007;31:657-64.
13. Apivatthakakul T, Arpornchayanon O, Bavornratanavech S. Minimally invasive plate osteosynthesis (MIPO) of the humeral shaft fracture. Is it possible? A cadaveric study and preliminary report. Injury 2005;36:530-8.
14. 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;41:169-72.
15. Ji F, Tong D, Tang H, Cai X, Zhang Q, Li J, Wang Q. Minimally invasive percutaneous plate osteosynthesis (MIPPO) technique applied in the treatment of humeral shaft distal fractures through a latera approach. Int Orthop 2009;33:543-7.
16. Zhiquan A, Bingfang Z, Xiaojian H, Qi Ch, Shundong H. Plating osteosynthesis of mid-distal humeral shaft fractures: minimally invasive versus conventional open reduction technique. Int Orthop 2010;34:131-5.
17. Oh CW, Byun YS, Oh JK, Kim JJ, Jeon IH, Lee JH,Park KH. Plating of humeral shaft fractures: Comparison of standard conventional plating versus minimally invasive plating. Orthopaedics & Traumatology: Surgery & Research 2012;98(1):54-60.
18. Lin J. Treatment of humeral shaft fractures with humeral locked nail and comparison with plate fixation. J Trauma 1998;44(5): 859-64.
19. Bell MJ, Beauchamp CG, Kellam JK, McMurtry RY. The results of plating humeral shaft fractures in patients with multiple injuries. The Sunnybrook experience. J Bone Joint Surg Br 1985;67:293-6.
20. Gregory PR, Sanders RW. Compression plating versus intramedullary fixation of humeral shaft fractures. J Am Acad Orthop Surg 1997;5:215-23.
21. 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;68:430-3.
22. McCormack RG, Brien D, Buckley RE, McKee MD, Powell J, Schemitsch EH. Fixation of fractures of the shaft of humerus by dynamic compression plate or intramedullary nail. A prospective, randomised trial. J Bone Joint Surg Br 2000;82:336-9.
23. Bhandari M, Devereaux PJ, McKee MD, Schemitsch EH. Compression plating versus intramedullary nailing of humeral shaft fractures - a meta-analysis. Acta Orthopaedica 2006;77(2):279-84.
24. Fu F. Using bioabsorbable interference screw fixation for hamstring ACL-reconstruction. Orthop Today 1997;16:37.
2. Eijer H, Hauke C, Arens S, Printzen G, Schlegel U, Perren SM. PC-Fix and local infection resistance – Influence of implant design on posoperative infection development, clinical and experimental results. Injury 2001;32(Suppl. 2):B38-43.
3. Wenda K, Runkel M, Degreif J, Rudig L. Minimally invasive plate fixation in femoral shaft fractures. Injury 1997;28(Suppl. 1): A13-9.
4. Baumgaertel F, Buhl M, Rahn BA. Fracture healing in biological plate osteosynthesis. Injury 1998;29(Suppl. 3):C3-6.
5. Baumgaertel F. Placa puente. En: Rüedy TP, Murphy WM, ed. Principios de la AO en el tratamiento de las fracturas. Barcelona:
Masson; 2003:221-30.
6. Müller ME, Nazarian S, Koch P, Schatzker J. The comprehensive classification of fractures of long bones. Springer, Berlin Heidelberg, New York; 1990.
7. Fernández Dell´Oca AA. The principle of helical implants. Unusual ideas worth considering. Injury 2002;33(Suppl. 1):SA1-27.
8. Livani B, Belangero WD. Bridging plate osteosynthesis of humeral shaft fractures. Injury 2004;35:587-95.
9. Rupenian P, Lebas G, Razza F. D’Assaro O. Osteosíntesis mínimamente invasiva en fracturas mediodiafisarias del húmero.
Informe de un caso y descripción de la técnica. Rev Asoc Argent Ortop Traumatol 2005;70(2):132-4.
10. Rupenian P, Lebas G, Razza F, Herrador M, D´Assaro O. Osteosíntesis mínimamente invasiva con placa helicoidal en fracturas
diafisarias del húmero con compromiso del tercio proximal. Rev Asoc Argent Ortop Traumatol 2005;70(3):252-5.
11. Perren SM. Evolution of the internal fixation of long bone fractures. J Bone Joint Surg Br 2002;84:1093-110.
12. Law TW, Leung F, Chan CF, Chow SP. Minimally invasive plate osteosynthesis in the treatment of proximal humeral fracture. Int Orthop 2007;31:657-64.
13. Apivatthakakul T, Arpornchayanon O, Bavornratanavech S. Minimally invasive plate osteosynthesis (MIPO) of the humeral shaft fracture. Is it possible? A cadaveric study and preliminary report. Injury 2005;36:530-8.
14. 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;41:169-72.
15. Ji F, Tong D, Tang H, Cai X, Zhang Q, Li J, Wang Q. Minimally invasive percutaneous plate osteosynthesis (MIPPO) technique applied in the treatment of humeral shaft distal fractures through a latera approach. Int Orthop 2009;33:543-7.
16. Zhiquan A, Bingfang Z, Xiaojian H, Qi Ch, Shundong H. Plating osteosynthesis of mid-distal humeral shaft fractures: minimally invasive versus conventional open reduction technique. Int Orthop 2010;34:131-5.
17. Oh CW, Byun YS, Oh JK, Kim JJ, Jeon IH, Lee JH,Park KH. Plating of humeral shaft fractures: Comparison of standard conventional plating versus minimally invasive plating. Orthopaedics & Traumatology: Surgery & Research 2012;98(1):54-60.
18. Lin J. Treatment of humeral shaft fractures with humeral locked nail and comparison with plate fixation. J Trauma 1998;44(5): 859-64.
19. Bell MJ, Beauchamp CG, Kellam JK, McMurtry RY. The results of plating humeral shaft fractures in patients with multiple injuries. The Sunnybrook experience. J Bone Joint Surg Br 1985;67:293-6.
20. Gregory PR, Sanders RW. Compression plating versus intramedullary fixation of humeral shaft fractures. J Am Acad Orthop Surg 1997;5:215-23.
21. 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;68:430-3.
22. McCormack RG, Brien D, Buckley RE, McKee MD, Powell J, Schemitsch EH. Fixation of fractures of the shaft of humerus by dynamic compression plate or intramedullary nail. A prospective, randomised trial. J Bone Joint Surg Br 2000;82:336-9.
23. Bhandari M, Devereaux PJ, McKee MD, Schemitsch EH. Compression plating versus intramedullary nailing of humeral shaft fractures - a meta-analysis. Acta Orthopaedica 2006;77(2):279-84.
24. Fu F. Using bioabsorbable interference screw fixation for hamstring ACL-reconstruction. Orthop Today 1997;16:37.