• 作者：J.M. Ferná ; ndez-Medina^a ; J.A. Cara-Del Rosal^a ; ^{jac.cara@terra.es} ; A. Narvá ; ez-Jim&#233 ; nez^a ; R. Ló ; pez-Ar&#233 ; valo^b
• 关键词：Hú ; mero ; Fractura ; Anatomí ; a ; Osteosí ; ntesis percutá ; nea con placa mí ; nimamente invasiva
• 刊名：Revista Espa帽ola de Cirug铆a Ortop茅dica y Traumatolog铆a
• 出版年：2009
• 期刊代码：pca311_18884415
• 类别：med
• 出版时间：September-October 2009
• 卷：53
• 期：5
• 页码：305-311
• 文件大小：5468 K

Purpose

To determine the feasibility of using minimally invasive percutaneous plate osteosynthesis (MIPPO) in the treatment of humeral shaft fractures and analyze the anatomical relations of the different bodily structures with the fixation plate.

Introduction

Humeral shaft fractures account for 1.6%of all surgical fractures. Open reduction and compression plate fixation is a universally accepted method, but since it requires an extended dissection it could cause a lesion to the radial nerve. Another alternative is to use intramedullary nails, but the percentage of complications associated to them is similar.

Materials and methods

We conducted a study of 5 cadavers. At the proximal level, we carried out a deltopectoral mini approach; the distal incision was performed at about 5 centimeters proximally to the elbow flexure in the inferomedial region of the arm. Once the two mini approaches were completed, a blunt instrument was used to drive an anterior extraperiosteal subbrachial tunnel on the anterior aspect of the humerus through which a 10-hole straight narrow plate was introduced from proximal to distal.

Results

Once the osteosynthesis was completed, we identified the relationship of the different anatomical structures with the plate, extending both incisions without finding any significant anatomical structure on the anterior aspect of the humerus that could be damaged.

Conclusions

Even if technically challenging, the MIPPO technique described herein is less invasive or traumatic than open reduction and plate fixation, and it is not associated with any special risks of injury to the radial or musculocutaneous nerves.