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Erschienen in:
01.09.2015 | Original Article
New mini-invasive posterior approach for humerus plating
Erschienen in: European Orthopaedics and Traumatology | Ausgabe 3/2015
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Background
Although the flat posterior surface of the humerus is more suitable for plating, but because of the radial nerve, only the anterior and lateral approaches were considered to be safe for humerus minimally invasive plate osteosynthesis (MIPO). After successful cadaveric dissection and protection of the radial nerve at the spiral groove through a small separate posterior incision, easy posterior MIPO was possible. We performed a prospective clinical study to evaluate the safety, feasibility, and the results of this new approach.
Patients and methods
Thirty skeletally mature patients with humeral diaphyseal fractures were managed by posterior MIPO between July 2007 and July 2013. The clinical outcome measurements included fracture healing, radial nerve palsy, infection, and functional assessments for the affected shoulders and elbows using the UCLA and Mayo elbow performance scoring systems, respectively. Radiographic measurements were time to union, alignment, and nonunion.
Results
The mean follow-up period was 24.6 ± 8.47 months. The radial nerve could be successfully developed through the middle incision in all patients. All the fractures united with accepted alignment in a mean time of 15.2 ± 4.37 weeks without any secondary procedure to achieve union. Excellent shoulder and elbow functions were encountered in all patients. All the patients could return to work in a mean time of 2.6 ± 1.54 months.
Conclusions
The posterior approach for humerus MIPO is possible, safe, feasible, and efficient.