Comparison of outcome in MIPO versus ORIF with plate Osteosynthesis in The Management of Fractures of the Shaft of Humerus

Abstract

Background: Fractures of the humeral shaft are usually managed surgically with ORIF (open reduction with internal fixation) with PO (plate osteosynthesis) being the most commonly used modality of treatment. With the advent of biological fracture fixation principles, the trend currently is to go in for minimally invasive techniques. The aim of this study was to compare the functional outcomes of humeral shaft fractures treated by ORIF and MIPO (minimally invasive plate osteosynthesis) and to compare the results with studies of other authors as available in literature. Methods: 30 patients with diaphyseal fractures of the humerus who presented between Jan 2014 to Jan 2016 were randomly allocated into 2 groups with Group 1 treated by ORIF with PO (N=15) and Group 2 treated by MIPO (n=15) and were followed up for a minimum period of 2 years. Functional outcomes of both groups were assessed by the DASH score. Results: Both groups were comparable in terms of age, sex, side predominance and mode of injury.According to fracture classification, AO type A was the most common type seen followed by type B and C. The mean follow up in group 1 was 26 months ranging from 24 to 31 months while it was 27 months in group 2 ranging from 25 to 30 months. There was a significant statistical difference in group 2 pertaining to operative time, blood loss and radiation exposure with the P value < 0.001. The time to union was shorter in group 2 and the DASH score in both groups improved over the course of follow up upto a year. Conclusion: By this study we conclude that MIPO of humeral shaft fractures is a good viable and easily reproducible option in the management of these fractures and has advantages over conventional ORIF techniques in terms of reduced blood loss, shorter surgical times and earlier time to fracture union by employing biological principles of fracture fixation and gives good functional results.