title: Minimally invasive plate osteosynthesis for proximal humeral fractures.
abstract: OBJECTIVE
  To report the outcome after minimally invasive plate osteosynthesis (MIPO) through the deltoid-splitting approach for proximal humeral fractures.
  
  
  METHODS
  10 men and 30 women aged 37 to 88 years underwent MIPO through the deltoid-splitting approach using the Proximal Humerus Internal Locking System or the Locking Proximal Humerus Plate for 2-part (n=18), 3-part (n=20), and 4-part (n=2) proximal humeral fractures. The rehabilitation protocol was standardised.
  
  
  RESULTS
  All 40 patients were followed up at 3 months, 34 (85%) at 6 months, 30 (75%) at one year, and 13 (33%) at 2 years. Two patients had malunion. No patient had avascular necrosis, infection, nerve palsy, or nonunion. The mean Constant score at one year and 2 years was 75 and 87.5, respectively. The Constant score at 6 months correlated to that at one year (r=0.926, p<0.0001) and at 2 years (r=0.874, p=0.0001). In younger patients, improvement in the range of motion was faster. The early plateau group (those with no further improvement after 6 months) and the late plateau group (those with no further improvement after one year) did not differ significantly in age, fracture grade, or hand dominance.
  
  
  CONCLUSIONS
  MIPO for fixation of proximal humeral fractures using a locking plate is safe and effective in enabling an early return of shoulder function.
authors: Department of Orthopaedics and Traumatology, The University of Hong Kong, Queen Mary Hospital, Hong Kong.
authors: Paul Aarne
authors: PA
authors: Koljonen
authors: Department of Orthopaedics and Traumatology, The University of Hong Kong, Queen Mary Hospital, Hong Kong.
authors: Christian
authors: C
authors: Fang
authors: Department of Orthopaedics and Traumatology, The University of Hong Kong, Queen Mary Hospital, Hong Kong.
authors: Tak Wing
authors: TW
authors: Lau
authors: Department of Orthopaedics and Traumatology, The University of Hong Kong, Queen Mary Hospital, Hong Kong.
authors: Frankie
authors: F
authors: Leung
authors: David Trench Rehabilitation Centre, Hong Kong.
authors: Nigel W K
authors: NW
authors: Cheung
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D006811:Humerus / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D016059:Range of Motion, Articular; D012784:Shoulder Fractures / Q000503:physiopathology / Q000601:surgery*
keywords: humeral fractures; treatment outcome