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No benefit in function seen with minimally invasive plate osteosynthesis for humeral shaft fractures
Compared with open reduction and internal fixation, minimally invasive plating osteosynthesis was linked with a higher rate of postoperative malrotation of greater than 20° and did not improve function or restore strength in patients with humeral shaft fractures.
Researchers prospectively evaluated 26 patients with humeral shaft fractures treated with minimally invasive plate osteosynthesis (MIPO) and 27 patients treated with open reduction and internal fixation (ORIF) at a level 1 trauma center. Investigators used CT scans to determine humeral retroversion angle and postoperative malrotation.
At 12 months postoperatively, patients were evaluated for union, muscle strength, Constant score and American Shoulder and Elbow Surgeons (ASES) score. In addition, investigators recorded patients’ degree of internal and external rotation.
Although investigators found a lower rate of nerve injury in the MIPO group vs. the ORIF group, this difference was not significant. In addition, they found no cases of infection or the need for additional surgery in these groups. Both ORIF and MIPO groups had excellent Constant scores, with no significant differences between the groups seen for these or ASES scores.
Investigators noted all patients had a considerable loss of muscle strength, with a significantly greater loss seen in internal rotation compared with external rotation. Investigators found 40.9% of patients in the MIPO group had postoperative malrotation of greater than 20 ° compared with 0% of patients in the ORIF group. ‒ by Monica Jaramillo
Disclosures: The researchers reports no relevant financial disclosures.