Fracture of Distal Humerus: MIPO Technique with Visualization of the Radial Nerve

Overview

Journal Acta Ortop Bras

Specialty Orthopedics

Date 2014 Dec 25

PMID 25538474

Citations 8

Authors

Daniel Romano Zogbi

Alberto Maranon Terrivel

Guilherme Grisi Mouraria

Mauricio Leal Dias Mongon

Fernando Kenji Kikuta

Americo Zoppi Filho

Affiliations

Soon will be listed here.

Abstract

Objectives: To evaluate the outcomes in patients treated for humerus distal third fractures with MIPO technique and visualization of the radial nerve by an accessory approach, in those without radial palsy before surgery.

Methods: The patients were treated with MIPO technique. The visualization and isolation of the radial nerve was done by an approach between the brachialis and the brachiorradialis, with an oblique incision, in the lateral side of the arm. MEPS was used to evaluate the elbow function.

Results: Seven patients were evaluated with a mean age of 29.8 years old. The average follow up was 29.85 months. The radial neuropraxis after surgery occurred in three patients. The sensorial recovery occurred after 3.16 months on average and also of the motor function, after 5.33 months on average, in all patients. We achieved fracture consolidation in all patients (M=4.22 months). The averages for flexion-extension and prono-supination were 112.85° and 145°, respectively. The MEPS average score was 86.42. There was no case of infection.

Conclusion: This approach allowed excluding a radial nerve interposition on site of the fracture and/or under the plate, showing a high level of consolidation of the fracture and a good evolution of the range of movement of the elbow. Level of Evidence IV, Case Series.

Citing Articles

Humeral shaft fracture: systematic review of non-operative and operative treatment.

Van Bergen S, Mahabier K, Van Lieshout E, Van der Torre T, Notenboom C, Jawahier P Arch Orthop Trauma Surg. 2023; 143(8):5035-5054.

PMID: 37093269 PMC: 10374687. DOI: 10.1007/s00402-023-04836-8.

Minimally invasive plate osteosynthesis (MIPO) for distal humeral fractures: a cadaveric study and first clinical application.

Hofmann V, Diepold J, Moursy M, Birke M, Deininger C, Wichlas F BMC Musculoskelet Disord. 2023; 24(1):206.

PMID: 36934262 PMC: 10024368. DOI: 10.1186/s12891-023-06189-0.

Comparison of three different surgical treatment methods in humeral shaft fractures.

Karagoz B, Erdem M, Cukurlu M, Agir I Pan Afr Med J. 2022; 42:88.

PMID: 36034025 PMC: 9379442. DOI: 10.11604/pamj.2022.42.88.34692.

New, Minimally Invasive, Anteromedial-Distal Approach for Plate Osteosynthesis of Distal-Third Humeral Shaft Fractures: An Anatomical Study.

Canada-Oya H, Canada-Oya S, Zarzuela-Jimenez C, Delgado-Martinez A JB JS Open Access. 2020; 5(1):e0056.

PMID: 32309762 PMC: 7147638. DOI: 10.2106/JBJS.OA.19.00056.

Polyaxial locking plates in treating distal humeral fractures: a comparative randomized trial for clinical outcome.

Cronlein M, Lucke M, Beirer M, Pforringer D, Kirchhoff C, Biberthaler P BMC Musculoskelet Disord. 2017; 18(1):547.

PMID: 29282027 PMC: 5745613. DOI: 10.1186/s12891-017-1910-9.

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