Minimal invasive percutaneous plate osteosynthesis (MIPPO) in humerus shaft fractures radiological and functional results

Objective: We aimed to evaluate the radiological and functional results of humeral shaft fractures treated with minimally invasive percutaneous plate osteosynthesis (MIPPO) in our clinic and to determine the positive and negative aspects of this technique. Materials and Methods: We retrospectively evaluated 27 humerus of 26 patients with the diagnosis of humeral shaft fracture who were admitted to our hospital with any trauma between October 2010 and July 2017, treated by MIPPO in our clinic at the age of 16 years or older. Six patients were inadequate. Demographic data, type of injury, fracture classification according to AO classification and fracture region, smoking and non-smoking, radial nerve injury were recorded in 20 patients included in the study. Radiographically, the union at 6 months and alignment were evaluated. Objective results were evaluated in terms of shoulder and elbow range of motion. Subjective results were assessed by the American Shoulder and Elbow Society (ASES), the University of California at Los Angeles (UCLA), the Mayo Elbow Performance Index (MEPI) and Hand (DASH) and Constant Shoulder Score. Results: The mean age of our study was 31.7 (16-84) years. 14 of the patients were male (70 %) and 6 (30 %) were female. Ten (47,6 %) of the humerus were on the right, and 11 (52.4 %) on the left. According to AO classification 1 fracture (4,8 %) classified as 12A1, 2 fractures (9,5 %) as 12A2, 10 fractures (47,6 %) as 12A3, 6 fractures (28,5 %) as 12B2 and 2 fractures (4.8 %) as 12C3. There were no peroperative radial nerve injury, implant failure and infection. Mean shoulder active flexion was 169.5 ± 26.4°, mean abduction was 169.5 ± 26.4°. The average elbow motion was 131.4° ± 19.8°. The mean ASES and UCLA scores were 88.5 ± 16.4 and 32.1 ± 5.2, respectively. The mean MEPI and DASH scores were 93.1 ± 11.3 and 11.8 ± 20.0, respectively, and the mean Constant score was 9.1 ± 15.3. Conclusion: We believe that minimally invasive percutaneous plate osteosynthesis (MIPPO) is a successful technique for the treatment of humeral shaft fractures with minimal soft tissue damage, intact shoulder and elbow motion function.