title: Effects of different surgical techniques on mid-distal humeral shaft vascularity: open reduction and internal fixation versus minimally invasive plate osteosynthesis.
abstract: Humeral shaft fractures are generally managed with the conventional posterior open reduction and internal fixation (ORIF) or minimally invasive plate osteosynthesis (MIPO). This study was aimed at comparing the outcomes of these surgical techniques in terms of the vascular integrity of the mid-distal humeral shaft.
  
  
  
  Twelve upper limbs were harvested from 6 fresh cadavers. ORIF or MIPO was randomly performed on either side of each pair of limbs. The axillary artery was perfused with a latex-lead tetraoxide red solution to visualize the vascular structures. The vascular integrity of the humerus was examined by plain radiography and dissection. The periosteal filling achieved with each technique was scored and the scores compared.
  
  
  
  In each limb, one main nutrient artery entering the mid-distal humeral shaft anteromedially (83.3 %) or medially (16.7 %) was first identified. No case of injury to the main nutrient artery was noted for either surgical technique. Injuries to the accessory nutrient arteries entering the mid-distal humeral shaft from the posterior aspect were absent in the MIPO cases, but occurred in 52.9 % of the ORIF cases. In addition, MIPO was also superior to the open plate technique showed superior periosteal filling than.
  
  
  
  Our results showed that the MIPO technique is superior to the ORIF in terms of preserving the vascular integrity of the mid-distal humeral shaft.
authors: Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No.600 Yishan Road, Shanghai, 200233, China.
authors: Zichao
authors: Z
authors: Xue
authors: Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No.600 Yishan Road, Shanghai, 200233, China.
authors: Chaolai
authors: C
authors: Jiang
authors: Department of Orthopaedic Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No.197 Rui Jin Er Road, Shanghai, 200025, China.
authors: Chuanzhen
authors: C
authors: Hu
authors: Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No.600 Yishan Road, Shanghai, 200233, China.
authors: Hui
authors: H
authors: Qin
authors: Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No.600 Yishan Road, Shanghai, 200233, China.
authors: Haoliang
authors: H
authors: Ding
authors: Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No.600 Yishan Road, Shanghai, 200233, China. anzhiquan@126.com.
authors: Zhiquan
authors: Z
authors: An
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery*; D006811:Humerus / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D010521:Periosteum
keywords: Blood supply; Humeral fracture; Internal fixation; Reduction