Which One is better for Surgical Treatment of Humeral Shaft Fractures? Conventional plating versus Minimal Invasive Approach

Year 2017, , 1 - 5, 01.01.2017

Hakan Şeşen Anıl Taşkesen Ahmet Safa Tağral Mahmut Özdemir İsmail Demirkale Murat Altay

https://doi.org/10.5505/abantmedj.2017.55706

Abstract

Introduction: Although the gold standard for surgical treatment of humerus shaft fractures is internal fixation there still controversy exists on the fixation method of choice. In this study, we aimed to compare the results of minimally invasive plate osteosynthesis MIPPO with posterior conventional plating ORIF of the humerus shaft fracture. Methods: Between January 2010 and December 2014, a retrospective study was conducted on 47 patients whom were operated for humerus fracture by internal fixation. Of them, 27 were performed ORIF Group A and 20 were performed MIPPO Group B technique. Each group was statistically compared for bony union time, functional scores, time to return work and operation time. Results: There were not statistically significant difference between two groups with regard to bony union time, functional scores and time to return to work p>0.05 . The mean bony union time in two groups was 16.37±2.55 weeks. The mean operation time in MIPPO group was lower and it was statistically significant 96.52±10.98’ye vs. 65.90±6.52

Keywords

humerus, shaft, fracture, surgery, MIPPO

Humerus Cisim Kırıklarının Cerrahi Tedavisinde Konvansiyonel Plaklama mı Minimal İnvaziv Plak Osteosentezi mi Daha Üstün?

Abstract

Giriş ve Amaç: Humerus cisim kırıklarının cerrahi tedavisinde internal tespit yöntemi altın standart olarak kabul edilse de internal tespitin hangi yöntemle yapılacağı konusunda fikir birliği yoktur. Bu çalışmada, humerus cisim kırığı nedeniyle internal tespit uygulanan hastalarda kullanılan minimal invaziv plaklama MİPPO ve posterior yaklaşımla konvansiyonel plaklama ARIF yöntemlerinin sonuçlarının karşılaştırılması amaçlanmıştır. Yöntem ve Gereçler: Ocak 2010 ile Aralık 2014 tarihleri arasında humerus cisim kırığı nedeniyle internal tespit uygulanan 47 hasta retrospektif olarak incelenmiştir. Bu hastalardan 27’sine ARIF Grup A , 20 hastaya ise 10 kadın 10 erkek MİPPO tekniği uygulandı Grup B . Her iki grupta kırık kaynama zamanı, fonksiyonel skorlama sonuçları, işe dönüş zamanı ve ameliyat süresi istatiksel olarak karşılaştırılmıştır. Bulgular: Her iki grupta kaynama zamanı, işe dönüş zamanı ve fonksiyonel skorlama sonuçları açısından fark yoktu p>0.05 . Ortalama kaynama süresi her iki grup için 16,37±2,55 hafta idi. Operasyon süresi karşılaştırıldığında MİPPO uygulanan hastalarda istatiksel olarak anlamlı fark tespit edildi 96,52±10,98’ye karşı 65,90±6,52

Keywords

humerus, cisim, kırık, cerrahi, MİPPO

References

• Igbigbi PS, Manda K. Epidemiology of humeral fractures in Malawi. Int Orthop 2004;28:338-41.
• Ekholm R, Ponzer S, Törnkvist H, Adami J, Tidermark J. The Holstein-Lewis humeral shaft fracture: aspects of radial nerve injury, primary treatment, and outcome. J Orthop Trauma 2008;22:693-7.
• Sarmiento A, Zagorski JB, Zych GA, Latta LL, Capps CA. Functional bracing for the treatment of fractures of the humeral diaphysis. J Bone Joint Surg Am 2000;82:478-86.
• Perren SM. Evolution of the internal fixation of long bone fractures. The scientific basis of biological internal fixation: choosing a new balance between stability and biology. J Bone Joint Surg Br 2002;84:1093-1110.
• Vander Griend R, Tomasin J, Ward EF. Open reduction and internal fixation of humeral shaft fractures. J Bone Joint Surg Am 1986;68:430-3.
• Bell MJ, Beauchamp CG, Kellam JK, McMurtry RY. JK, The results of plating humeral shaft fractures in patients with multiple injuries. J Bone Joint Surg Br 1985;67:293-6.
• Tingstad EM, Wolinsky PR, Shyry Y, Johnson KD. Effect of immediate weightbearing on plated fractures of the humeral shaft. J Trauma 2000;49:278-80.
• Yang KH. Helical plate fixation for treatment of comminuted fractures of the proximal and middle one- third of the humerus. Injury 2005;36:75-80.
• Zhiquan A, Bingfang Z, Yeming W, Chi Z, Peiyan H. Minimally invasive plating osteosynthesis (MIPO) of middle and distal third humeral shaft fractures. J Orthop Trauma 2007;21:628-33.
• Apivatthakakul T, Arpornchayanon O, Bavornratanavech S. Minimally invasive plate osteosynthesis (MIPO) of the humeral shaft fracture. Is it possible? A cadaveric study and preliminary report. Injury 2005;36:530-8.
• Livani B, Belangero WD. Bridging plate osteosynthesis of humeral shaft fractures. Injury 2004;35:587-95.
• Huri G, Biçer ÖS, Öztürk H, Deveci MA, Tan I. Functional outcomes of minimal invasive percutaneous plate osteosynthesis (MIPPO) in humerus shaft fractures: a clinical study. Acta Orthop Traumatol Turc 2014;48:406- 12.
• Toivanen JA, Nieminen J, Laine HJ, Honkonen SE, Jarvinen MJ. Functional treatment of closed humeral shaft fractures. Int Orthop 2005;29:10-3.