title: Minimally invasive plate osteosynthesis using a locking compression plate for diaphyseal humeral fractures.
abstract: OBJECTIVE
  To assess outcomes of minimally invasive plate osteosynthesis (MIPO) using a locking compression plate (LCP) for 42 humeral shaft fractures. METHODS. 28 men and 14 women aged 18 to 68 (mean, 34; median, 29) years underwent closed reduction and MIPO using a LCP for type 12-A (n=26) and type 12-B (n=16) humeral shaft fractures. Eight of the patients were aged ≥ 50 years. Patients were followed up monthly until radiological union in at least 3 of the 4 cortices. Functional assessment was based on the Disabilities of Arm, Shoulder and Hand (DASH) score.
  
  
  RESULTS
  The mean follow-up period was 25 (range, 14-35) months. The mean DASH score was 35.1 at month 3 and improved to 8.9 at month 6 and 5.2 at year 1. The mean angulation was 4º in the coronal plane and 7º in the sagittal plane. All fractures united after a mean of 14 weeks. Two patients with transverse fractures had delayed union and received bone marrow injections at 12 or 13 weeks; they achieved union at week 20. One patient developed a radial nerve palsy immediately after surgery and underwent surgical exploration through the anterolateral approach. The plate was re-applied, and the nerve recovered in 48 hours with full power in all the muscle groups.
  
  
  CONCLUSIONS
  MIPO with LCP is a safe and effective technique for fixation of diaphyseal humeral fractures, and results in faster bone union, better cosmesis, and minimal complications.
authors.affiliation: Department of Orthopaedics, Delhi Institute of Trauma and Orthopaedics, Sant Parmanand Hospital, New Delhi, India.
authors.forename: Sachit
authors.initials: S
authors.lastname: Malhan
authors.forename: Simon
authors.initials: S
authors.lastname: Thomas
authors.forename: Shekhar
authors.initials: S
authors.lastname: Srivastav
authors.forename: Sshekhar
authors.initials: S
authors.lastname: Agarwal
authors.forename: Vivek
authors.initials: V
authors.lastname: Mittal
authors.forename: Biren
authors.initials: B
authors.lastname: Nadkarni
authors.forename: Divesh
authors.initials: D
authors.lastname: Gulati
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001860:Bone Plates; D004551:Elbow Joint / Q000503:physiopathology; D004867:Equipment Design; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D006810:Humeral Fractures / Q000145:classification / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D011859:Radiography; D016059:Range of Motion, Articular; D012785:Shoulder Joint / Q000503:physiopathology; D016896:Treatment Outcome; D055815:Young Adult