title: Complications and outcomes of minimally invasive percutaneous plating for proximal humeral fractures.
abstract: BACKGROUND
  The minimally invasive plate osteosynthesis (MIPO) technique using periarticular locking plates may be a good option for the repair of displaced proximal humeral fractures. However, axillary nerve complications related to this technique may be underestimated. The purpose of this study is to evaluate the outcomes of the minimally invasive plating, focusing on the complications.
  
  
  METHODS
  The records of 21 consecutive patients treated for proximal humerus fractures using the MIPO technique with locking plates were retrospectively reviewed. These patients were treated between March 2009 and March 2011 with a minimum one-year follow-up. The clinical function, complications, and radiological bony union were evaluated.
  
  
  RESULTS
  All of the patients, with one exception, showed at least 90 degrees of flexion and abduction at the shoulder joint six months postoperatively. The average Constant scores at three months, six months, and one year follow-ups were 74.0 (range, 62 to 90), 79.4 (range, 64 to 91), and 82.7 (range, 66 to 92), respectively. All of the patients achieved bony union within the average of 3.2 months (range, 2 to 6 months). There was one case of delayed union, one case of intra-articular screw penetration, and one case of axillary nerve paresis (incomplete injury), which did not completely recover during the one year of follow-up.
  
  
  CONCLUSIONS
  The MIPO technique using periarticular locking plates is a useful option for the treatment of selected cases of displaced proximal humeral fractures. However, nerve complications such as axillary nerve paresis should be considered along with implant-related complications when choosing patients for minimally invasive plating.
authors.affiliation: Department of Orthopedic Surgery, Chonbuk National University Medical School and Research Institute of Clinical Medicine, Chonbuk National University, Jeonju, Korea. ; Department of Orthopedic Surgery, International St. Mary's Hospital, Incheon, Korea.
authors.forename: Jin
authors.initials: J
authors.lastname: Park
authors.affiliation: Department of Orthopedic Surgery, Chonbuk National University Medical School and Research Institute of Clinical Medicine, Chonbuk National University, Jeonju, Korea.
authors.forename: Seong Yup
authors.initials: SY
authors.lastname: Jeong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects; D059348:Peripheral Nerve Injuries / Q000209:etiology; D012189:Retrospective Studies; D012784:Shoulder Fractures / Q000601:surgery*; D055815:Young Adult
keywords: Axillary nerve; Fracture; Humerus; Locking plate; Minimally invasive