COMPARATIVE ANALYSIS OF OUTCOMES OF MINIMALLY INVASIVE VS CONVENTIONAL PLATE OSTEOSYNTHESIS FOR MIDDISTAL THIRD OF HUMERAL SHAFT FRACTURES

Relevance. Humeral shaft fractures in middistal third are more common for young patients; they can be open and be included in polytrauma cases. Operative treatment is preferable via minimally invasive or conventional plate osteosynthesis.

Intention. To compare outcomes in two similar clinical groups of patients with fractures of the humeral diaphysis in its distal and middle thirds after using a minimally invasive plate osteosynthesis (MIPO) and open reduction internal fixation (ORIF), trough posterior approach.

Methodology. Two comparable groups of patients with the above fractures were studied (20 MIPO and 22 ORIF surgeries). Intervention time, restoration of humeral anatomy, functional results and complications were assessed 1, 6, 12, 18 and 24 weeks after surgery. Clinical, radiographic and statistical methods were used.

Results and discussion. Mean surgery duration was similar in the groups. Restoration of humeral anatomy in MIPO group was achieved by close reduction in all cases. The majority of MIPO patients showed good functional results by 12th week after surgery. In ORIF group restoration of function was insignificantly delayed (p > 0.05). Complications were observed in 2 (10 %) MIPO patients and 6 (27 %) ORIF patients; in the latter group, postoperative radial nerve palsy predominated.

Conclusion. MIPO method is safe and effective for all types of middistal humeral shaft fractures. Because of high risk of postoperative radial nerve palsy, ORIF should be limited to simple fractures of lower part of the humeral diaphysis.

traumatology, humeral shaft fracture, plate osteosynthesis, minimally invasive plate osteosynthesis

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