Is MIPO in humeral shaft fractures really safe? Postoperative ultrasonographic evaluation.
In the last few years there has been great interest in minimally invasive plate osteosynthesis (MIPO) in the treatment of humeral shaft fractures. None of these studies showed the anatomical relationship between the radial nerve and the material of the implant in vivo. We performed postoperative ultrasonographic measurement of the distance between the radial nerve and the material implanted using the MIPO technique. Nineteen patients underwent postoperative ultrasound examinations. Group A comprised midshaft fractures and group B distal third fractures. The point of greatest proximity between the radial nerve and the implant was measured. In group A the distance was between 1.6 and 19.6 mm (mean: 9.3 mm) and in group B between 1.0 and 8.1 mm (mean: 4.0 mm). The ultrasound findings reveal that the radial nerve is quite close to the implant material, especially in the transition between the third and fourth quarters of the humeral shaft.
Livani
Bruno
B
Department of Orthopaedics and Traumatology, UNICAMP, Campinas, Brazil. brunolivani@hotmail.com
Belangero
William
W
Andrade
Kleber
K
Zuiani
Guilherme
G
Pratali
Raphael
R
D000328:Adult; D000368:Aged; D001860:Bone Plates / Q000009:adverse effects; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D006810:Humeral Fractures / Q000000981:diagnostic imaging* / Q000601:surgery*; D016268:Internal Fixators / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D011184:Postoperative Period; D011826:Radial Nerve / Q000000981:diagnostic imaging / Q000293:injuries; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014463:Ultrasonography