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Minimally Invasive Plate Osteosynthesis Using a Screw Compression Method for Treatment of Humeral Shaft Fractures

  • Ko, Sang-Hun (Department of Orthopedic Surgery, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Cha, Jae-Ryong (Department of Orthopedic Surgery, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Lee, Chae Chil (Department of Orthopedic Surgery, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Joo, Yong Tae (Department of Orthopedic Surgery, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Eom, Kyeong Su (Department of Orthopedic Surgery, Ulsan University Hospital, University of Ulsan College of Medicine)
  • Received : 2017.07.12
  • Accepted : 2017.09.25
  • Published : 2017.12.01

Abstract

Background: This study aims to compare the surgical outcomes of open reduction and internal fixation (ORIF) and minimally invasive plate osteosynthesis (MIPO) using a screw compression method in simple humeral shaft fractures. Methods: This retrospective study was performed with 50 patients who had surgical interventions for the treatment of simple humeral shaft fractures and had follow-ups of at least 12 months in Ulsan University Hospital between August 2008 and June 2015. Group 1 included 23 patients treated with ORIF and group 2 included 27 patients treated with the MIPO technique using a locking screw plate. The time to clinical/radiographic union, the joint range of motion (ROM), and function were evaluated. Results: The average time to clinical/radiographic bone union was shorter in group 2 ($12.0{\pm}3.7weeks/14.8{\pm}2.0weeks$ in group 1 and $9.4{\pm}1.3 weeks/12.0{\pm}3.3$ weeks in group 2; p = 0.022/p = 0.034). Shoulder and elbow joint function evaluated by joint ROM and visual analogue scale (VAS), Korean Shoulder Elbow Society (KSS), American Shoulder and Elbow Surgeons (ASES), and the University of California at Los Angeles (UCLA) scores was excellent in both groups. On the average shoulder ROM at 12 months after the operation, group 1 had forward elevation of $160^{\circ}$, external rotation of $30^{\circ}$ in adduction and lumbar vertebra 10 level in internal rotation and group 2 had forward elevation of $170^{\circ}$, external rotation of $35^{\circ}$ in adduction and lumbar vertebra 9 level in internal rotation. The mean VAS, KSS, ASES, and UCLA scores were 2.8, $87.0{\pm}0.9$, $89.4{\pm}0.9$, and $31.0{\pm}1.4$, respectively, in group 1 and 1.7, $89.1{\pm}2.7$, $91.0{\pm}1.6$, and $32.4{\pm}3.2$, respectively, in group 2. There were statistically significant intergroup differences in VAS score (p = 0.011). There were significantly less postoperative infections in group 2 (three cases, 10.7% in group 1 and 0 case in group 2; p = 0.041) although all of them were superficial infections and well-treated by an average 4-week course of antibiotics (range, 2 to 6 weeks). Conclusions: MIPO using a screw compression method in simple humeral shaft fractures demonstrated superior efficacy to ORIF in terms of the time to clinical/radiographic union, pain score, and postoperative infection rate.

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Cited by

  1. Assessment of Shoulder Function after Internal Fixation of Humeral Diaphyseal Fractures in Young Adults: A Prospective Comparative Study vol.2021, pp.None, 2017, https://doi.org/10.1155/2021/9471009