Treatment of humerus fracture with minimally invasive plate osteosynthesis (MIPO)

Abstract

Minimally invasive technical volar plate osteosynthesis has gained popularity with
satisfactory clinical results and advantages over other methods such as: open reduction
and plate osteosynthesis, antegrade or retrograde endomedullar nail osteosynthesis.
In this technique, the plate is inserted through a percutaneous approach with separate proximal and distal anterior incisions, causing less damage to the soft tissues, preserving the fracture hematoma and the blood supply to the bone fragments, accepting a non- anatomical reduction. 
Material and methods: We present a series of 7 cases, with a minimum follow-up of 6
months and a maximum of 3 years, in which we performed osteosynthesis with a volar
plate with a minimally invasive technique, we used narrow large-fragment LCP plates
in 6 patients with diaphyseal fractures of the humerus and in one patient we used a
molded Philos plate, due to a proximal humerus dislocation fracture. We carried out the post- operative radiographic follow-up at 3, 6 and 12 months of evolution.
Procedure: We perform the osteosynthesis with a volar plate with two incisions, proximal and distal, indirect reduction, with the help of an image intensifier, we place 2 or 3 proximal and distal screws, for the definitive fixation of the osteosynthesis.

Results:The fractures consolidated at 3 months postoperatively, shoulder and elbow
mobility recovered to that existing in the preoperative period, there was no infection
at the surgical site and no patient presented radial nerve injury.