A STUDY OF FUNCTIONAL, CLINICAL AND RADIOLOGICAL OUTCOME OF FRACTURE SHAFT OF HUMERUS MID AND DISTAL THIRD MANAGED BY MIPPO TECHNIQUE.

Corresponding Author:
Dr. Subramanian Karunanithi,
Plot No.54 & 55,
Door No.6/1552, Anand Nagar,
No. 1 Tollgate, Bikshandar Koil,
Mannachanallur Taluk, Trichy-621216.
E-mail: rajijipmer@yahoo.co.in

ABSTRACT

BACKGROUND

Minimally invasive percutaneous plate osteosynthesis (MIPPO) technique through the anterior approach has been widely used to treat humeral shaft fractures in recent years, because of its technical advantages and satisfactory clinical outcomes.

OBJECTIVES

• To observe the anatomical relationship between the radial nerve and plate during supination and pronation of forearm, so as to determine which position of forearm is safest for radial nerve in distal humerus.
• To determine the feasibility of MIPPO technique in the treatment of humeral shaft fractures (Middle and distal 1/3) through lateral approach.

METHODS

We began our study by dissecting eight arms of four cadavers to ascertain the anatomical relationship between the radial nerve and the plate. This was a prospective study including eight patients above 20 years of age with closed fracture shaft of humerus (Middle and distal third) from 2010 to 2012.

RESULTS

• Surgical delay post injury - 11.16 days (5-12 days)
• Mean operation time - 71.33 minutes (55-85 minutes)
• Mean follow-up duration - 9.2 wks. (4 -14 wks.)
• Mean healing time (when bridging callus was seen) - 8.3 wks. (6-13 wks.)
• Functional recovery was good (UCLA and MEPS score)

CONCLUSION

• MIPPO is safe and effective, alternative to open techniques.
• This is a biological fixation, which preserves the fracture haematoma and blood supply to the bone fragments and short operating time.

KEYWORDS

MIPPO, Shaft of Humerus Fracture, Anterior Approach.