Minimally invasive treatment of humeral multi-fractures with a locking compression plate

Abstract

Objective To investigate the efficacy of minimally invasive treatment of humeral multi-fractures with a locking compression plate through the anterior humeral approach. Methods From March 2005 to October 2008, 22 cases of unstable humeral multi-fractures were treated by the above method.Of them, 12 were injured in a traffic accident and 10 in daily life. There were 13 males and 9 females, with a mean age of 63.4 (ranging from 46 to 78) years. The left side was involved in 7cases, and the right side was involved in 14 cases. According to X-rays, 11 were fractures of humeral shaft and proximal humerus, 8 were fractures of humeral shaft and distal humerus, 2 were fractures of humeral shaft and proximal humerus and shoulder dislocation, and one case was fractures of humeral shaft, proximal and distal humerus and shoulder dislocation. Of them, 2 had emergency treatment of the injured radial nerve and internal fixation with Philos plate. Results The mean operative time was 107.9 min(range, 78 ～ 150 min ), and operative blood loss was 274 mL (range, 110 ～ 450 mL). In this group, 20 patients were followed up for 8 to 22 (average, 9. 4)months. All these patients had bone healing in 8 to 16 (average, 11.5) weeks. By Neer evaluation system,12 cases were rated as excellent, 5 as good, and 3 as fine, with the excellent-to-good rate being 85.0%. The function of elbow was rated by HSS as excellent in 16 cases and good in 4, with the excellent-to-good rate being 100%. Conclusion Minimally invasive treatment with a locking compression plate through anterior humeral approach is an effective and safe method for treating the humeral multi-fractures. Key words: Humeral fractures; Fracture fixation, internal; Surgical procedures, minimally invasive; Internal fixator