Minimally Invasive Plate Osteosynthesis for humeral shaft fractures: a systematic review

Sarhan, Mohamed; Hegazy, Mohamed; Montaser, Mohamed Goda; El-Hammady, Adel

doi:10.21608/bmfj.2023.237050.1901

Minimally Invasive Plate Osteosynthesis for humeral shaft fractures: a systematic review

Articles in Press

Document Type : Review Article

Authors

¹ Orthopedic Surgery, Ahmed Maher Teaching Hospital

² Orthopedic Department, Faculty Of medicine, Benha University

³ Orthopedric Department, Faculty of Medicine, Benha University

⁴ Orthopedic Department, Faculty of medicine, Benha Univeristy

10.21608/bmfj.2023.237050.1901

Abstract

Background: Fractures of the humeral shaft comprise 1% to 3% of all fractures. Incidence rates increase during the third and seventh decades.
Aim: systematic review of minimally invasive plate osteosynthesis for humeral shaft fractures in comparison to other methods of operative treatment.
Methods: conducted according to the methods described in the Cochrane Handbook and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines statement. A search of three electronic medical databases was performed: Google Scholar, PubMed, and the Cochrane Central Register of Controlled Trials to identify relevant trials until August 2017.
Results: 198 patients had MIPO technique resulting in 7 non-united fractures representing 3.5 %, 102 patients had IMN resulting in 9 non-united fractures representing 8.8% and 80 patients had ORPF resulting in 4 non-united fractures representing 5 %. Iatrogenic radial nerve palsy incidence with the MIPO technique was 3.5%. It was 8.7 %, 4.9% with ORPF and IMN respectively. The incidence of post-operative infection was 2 % in MIPO technique while it was 3.8 % and 6.9 % in ORPF and IMN respectively. No significant difference between MIPO technique and ORPF in the functional outcome of the shoulder. MIPO technique had a better shoulder functional outcomes than IMN.
Conclusion: Humeral shaft fractures could be effectively treated with the MIPO technique due to shorter fracture union time and lower incidence of nonunion, iatrogenic radial nerve palsies, iatrogenic fractures and infections rather than the conventional ORPF technique and IMN, with less operative scars and better cosmesis.

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