Revista de la Asociación Argentina de Ortopedia y Traumatología (Aug 2016)
Minimally invasive percutaneous lateral plate osteosynthesis in humeral shaft fractures.
Abstract
Introduction: The aim of this study is to retrospectively assess functional and radiological outcomes, and immediate and long term postsurgical complications in a series of patients with humeral fractures treated with osteosynthesis with minimally invasive technique. Material and Methods: Retrospective Multicentric study of 14 patients with humeral fractures treated with minimally invasive plate osteosynthesis through lateral approaches between 2007 and 2013. Seven were females and 7 males, age averaged 48.7 years (range 21 -73). Fractures were classified according to the AO classification A1 12 n: 1; 12 B1 n: 1; 12B2 n: 3; C1 n 12: 6; 12C2 n: 1; 12C3 n: 2. Two lateral incisions were used proximal and distal. The plates were slid submuscular, and the radial nerve was protected. Results: Follow - up averaged 30 months.Union was achieved in 13 cases (92.85%), time to union averaged three months (range, 2 to 6). Flexion averaged 174.8 °, external rotation 67.2°, abduction 173.8º and internal rotation 72.1°. Elbow flexion and extension ROM averaged 140.5 °. Constant´s score averaged 82.66 points; DASH score averaged 15.27 points. Four patients had radial nerve neurapraxia (23.5%). Discussion: Percutaneous osteosynthesis with plates using a lateral minimally invasive approach has proven effective for the treatment of humeral shaft fractures, applying the principle of bridge plate. It is a biological procedure, technically demanding, and not exempt of complications.
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