Minimally invasive percutaneous plate osteosynthesis for Neer three-part fractures of proximal humerus in young adults

Abstract

Objective To evaluate the efficacy of minimally invasive percutaneous plate osteosynthesis (MIPPO) in the treatment of Neer three-part fractures of the proximal humerus in young adults. Methods A retrospective analysis was performed of the 46 patients aged < 65 years with Neer three-part fracture of the proximal humerus from March 2010 to December 2016. MIPPO with locking proximal humerus plate (LPHP) was used in 23 of them who were 12 men and 11 women with an average age of 41.6±1.2 years; open reduction and internal fixation (ORIF) with LPHP was used in the other 23 patients who were 14 men and 9 women with an average age of 42.2±1.6 years. The 2 groups were compared in terms of operation time, intraoperative bleed-ing, fracture healing time and shoulder function by Neer scoring at the last follow-up. Results The average follow-up (13.4±1.2 months) for the MIPPO groups was not statistically different from that for the ORIF group (14.2±2.4 months) (P >0.05). The MIPPO group reported significantly shorter operation time (105±15 min), significantly less intraoperative bleeding (140±50 mL), significantly shorter fracture healing time(4.2±0.6 months), and significantly higher shoulder Neer scores (88.6±3.4) than the ORIF group (120±20 min, 320±40 mL, 5.4±1.2 months, and 81.6±2.2, respectively) (P 0.05). Conclusion MIPPO with LPHP may be obviously advantageous over ORIF with LPHP in the treatment of proximal humeral fractures in young adults. Key words: Shoulder fractures; Fracture fixation, internal; Bone plates; Surgical procedures, minimally invasive