Background: Complex metaphyseo-diaphyseal fractures of the
humerus shaft are difficult to treat with closed intramedullary nails.
On the other hand, open reduction and fixation by classic plates
require large incisions with negative effect on vascularity and vitality
of bone fragments. The purpose of the current study was to assess the
outcome of minimally invasive percutaneous plating of complex
metaphyseo-diaphyseal humeral fractures.
Patients and Methods: Eighteen patients with complex proximal
humeral fractures with diaphyseal extension were operated upon
using long PHILOS plates, through percutaneous minimally invasive
technique. There were 12 males and 6 females with average age of 45
years (range 32 to 56 years). All fractures were acute with average
time to fixation 3.2 days (range 1-6 days).
Results: complete union was obtained in all cases in good alignment
and with good shoulder and elbow function. Average time of union
was 15 weeks (range 9-21 weeks). Two cases developed postoperative
radial nerve palsy that was recovered after 3 weeks in the
first case and 9 weeks in the second case. There were no obvious
neurovascular injuries, nor major complications.
Conclusion: Mini-invasive percutaneous plating for complex
metaphyseo-diaphyseal humeral fractures is feasible, safe, with good
clinical outcome. There were no obvious neurovascular injuries, nor
major complications.