Functional and clinical outcome of minimally invasive anterior bridge platting in humerus shaft fractures

Abstract

Introduction: To assess the functional and radiological outcomes of minimally invasive anterior bridge plating (ABP) for mid-shaft humerus fractures. This study is done to evaluated the clinical, radiological, and functional outcome of mid shaft humerus fractures in 30 patients, all of which were managed with MIPPO. over an average follow up period of 12 months.Materials and Method: 30 patients fulfilling inclusion criteria were treated with ABP by using a 4.5-mm dynamic/locking compression plate and followed for a period of 12 month. Functional outcome was assessed using the UCLA & Mayo elbow scores. Range of motion (ROM), subjective strength, and radiographic union were assessed.Results: Out of the 30 patients in the study, 24 were males and 6 were females. The mean age was 36 years (range 26 to 65 years). 22 out of 30 patients (73%) had the dominant side fractured. Mean surgical time in minutes was 60 min (range: 35-80 min).The mean fracture union (radiological) time was 10.6 weeks (range: 08–16 weeks). However Shoulder function was excellent to good in 28 cases (93.3%) and fair in 2 case (6.7%) on the UCLA score and excellent in 28 cases(93.3%) and fair in 2 cases (6.7%) on mayo elbow score.The majority of patients (28 patients, 93.3%) who fell in the excellent or very good category according to our questionnaire were extremely satisfied. There were 2 cases (6.7%) of non-union.Conclusion: ABP is fundamentally different from traditional open posterior plating or conventional intramedullary nailing. It works on the principal of relative stability with union taking place by callus formation, and a longer plate on the tensile surface ensures that the humerus can withstand greater amount of rotational and bending stresses. The minimally invasive nature preserves the soft tissue envelope and, if done correctly, causes no damage to the vital structures in proximity. ABP for mid-shaft humerus fractures is a safe and effective treatment modality yielding high rates of union, excellent functional recovery, minimal biological disruption, better cosmesis, and superior satisfaction rates.