Fixation of humeral shaft fractures using minimally invasive plate osteosynthesis with two screws on each side, are results promising?

Aim: To assess the radiological and functional outcomes of minimally invasive plate osteosynthesis in treating diaphyseal humeral fractures using a plate with only two screws (relative stability) on either side of the fracture.

Material and Methods: A prospective study was conducted on 20 patients, which included patients with humeral shaft fractures treated by minimally invasive plating from September 2019 to June 2021. All patients were handled using a minimally invasive approach, closed reduction was performed, and 10 to 13 holes 4.5 mm plates were used over the anterior aspect of the humerus in bridging mode. Shoulder and elbow functions were evaluated at every follow-up using the University of California at Los Angeles Shoulder Score (UCLA) and Mayo Elbow Performance Score (MEPS).

Results: 16 men and 4 women comprised the study's twenty patients who were tracked for at least 12 months. Age was 34.2 years on average (range, 18 years-60 years). Eight of 20 patients (40%) had fractures on the dominant side. The average surgical time was 69.1 minutes (range, 50 min-90 min). The average radiological fracture union took 13.6 weeks to occur (range: 12 weeks-20 weeks). According to UCLA scores, shoulder function was excellent in 13 cases (65%), good in 7 cases (35%) at one year follow up.19 patients (95%) had excellent Mayo elbow performance score at one year follow up.

Conclusion: The MIPO approach for treating humeral shaft fractures provides good functional outcomes and should be regarded as a successful, cosmetically enhanced surgical option. When the surgeon is skilled in the technique, this approach is a safe and less invasive method for all forms of humeral shaft fractures.