Minimally invasive percutaneous osteosynthesis with locking plate in a series of 21 patients with humeral shaft fracture

Minimally invasive percutaneous plate osteosynthesis (MIPPO) has recently been proposed in the treatment of humeral shaft fractures. It is usually performed by percutaneous plate application to the anterior aspect of the humerus using two anterior windows (proximal and distal) without preliminary direct control of the radial nerve. However routine utilization of this method remains very limited because of the risk of iatrogenic radial nerve injury. We report herein our experience using a novel method of MIPPO in 21 patients with fracture of the proximal half of the humeral shaft; this technique consists on percutaneous application of bridge locking plate to the lateral aspect of the humeral shaft using two lateral windows (proximal and distal) after direct control and protection of the radial nerve. The goal of this study is to assess the feasibility and safety of this surgical method in the treatment of fractures of the proximal half of the humeral shaft as well as to evaluate its radio-clinical outcomes.
Keywords: Humeral shaft fractures; minimally invasive percutaneous plate osteosynthesis (MIPPO); biological osteosynthesis with locking plate

Ali Hassan Chamseddine, Oussama El-Hajj, Hussein Farhat, Ali Asfour
Service de Chirurgie Orthopédique et Traumatologie (Professeur Chamseddine). Hôpital Sahel - Centre Hospitalier Universitaire. Faculté des Sciences Médicales - Université Libanaise. Beyrouth. Liban