title: A prospective randomized study of operative treatment for noncomminuted humeral shaft fractures: conventional open plating versus minimal invasive plate osteosynthesis.
abstract: OBJECTIVE
  To compare the clinical and radiologic results of conventional open plating (COP) and minimally invasive plate osteosynthesis (MIPO) in the treatment of noncomminuted humeral shaft fractures.
  
  
  METHODS
  Randomized prospective study.
  
  
  METHODS
  Five level 1 trauma centers.
  
  
  METHODS
  Sixty-eight consecutive patients were randomized into 2 study groups: those treated by COP (COP group; n = 32) and those treated by MIPO (MIPO group; n = 36).
  
  
  METHODS
  Simple humeral shaft fractures (AO/OTA classification types A and B) were reduced by open reduction or closed reduction and fixed with a narrow 4.5/5.0 locking compression plate, metaphyseal locking compression plate, or proximal humeral internal locking system plate to the anterior lateral aspect of the humerus.
  
  
  METHODS
  Fracture healing time, operative time, radiation exposure time, and intraoperative nerve injury. To assess shoulder and elbow function, we used the University of California, Los Angeles (UCLA) scoring system and the Mayo elbow performance index, including the range of motion and pain. Radiographic measurements included fracture alignment, delayed union, and nonunion.
  
  
  RESULTS
  Thirty-one fractures (97%) healed in the COP group within 16 weeks, whereas 36 fractures (100%) were healed in the MIPO group by 15 weeks. No significant difference was observed in the operative time or complication rates. In both groups, all fractures achieved union without malunion and with excellent functional outcomes by definition of the Mayo elbow performance index and UCLA scoring system.
  
  
  CONCLUSIONS
  This study confirmed a high overall rate of union and excellent functional outcomes in both MIPO and COP groups. MIPO is equivalent to COP as a safe and effective method for simple types of humeral shaft fractures when surgery is indicated, and the surgeon is experienced in the technique.
  
  
  METHODS
  Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: *Department of Orthopaedic Surgery, Haeundae Paik Hospital, Inje University, Busan, Korea; †Department of Orthopaedic Surgery, Kyungpook National University Hospital, Daegu, Korea; ‡Department of Orthopaedic Surgery, Daegu Fatima Hospital, Daegu, Korea; §Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan, Seoul, Korea; and ‖Department of Orthopaedic Surgery, Hanyang University Guri Hospital, Hanyang University, Guri, Korea.
authors.forename: Ji Wan
authors.initials: JW
authors.lastname: Kim
authors.forename: Chang-Wug
authors.initials: CW
authors.lastname: Oh
authors.forename: Young-Soo
authors.initials: YS
authors.lastname: Byun
authors.forename: Jung Jae
authors.initials: JJ
authors.lastname: Kim
authors.forename: Ki Chul
authors.initials: KC
authors.lastname: Park
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods; D017102:Fracture Healing; D005599:Fractures, Ununited; D006801:Humans; D006810:Humeral Fractures / Q000175:diagnosis* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation*; D010027:Osteotomy / Q000295:instrumentation* / Q000379:methods; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult