Introduction: Humeral shaft fracture is one of the common injuries encountered in orthopedic surgery accounting for 1% - 5% of all fractures. Although nonoperative treatment of humeral shaft fracture is associated with satisfying clinical and functional outcomes in most cases, usually results in varus deformity and limitation of shoulder and elbow motion in some patients. Thus, orthopedic surgeons prefer operative management due to early return to function and low compliance of the patients.
Materials and Methods: 29 patients with diaphyseal fractures of the humerus treated with MIPO between January 2015 and June 2016 were included in the study. Patients with metabolic bone disease, polytrauma, and Gustilo and Anderson type 2 and 3 open fractures were excluded from the study. All patients having diaphyseal humerus fracture were treated with closed indirect reduction and plate fixation 4.5 dynamic compression plate using the MIPO technique. The surgery time, and time for union was noted. The shoulder and elbow function were assessed using the UCLA shoulder and Mayo elbow performance scores, respectively in follow up examination.
Results: Of the 32 patients in the study, 16 were males and 13 were females. The mean age was 34.5 years (Range: 18-58 years). Twenty of the twenty nine patients had the dominant side fractured. We had six cases of C1 and A2 type; three cases of A1, B2 and C3 type; four cases of B1 type; two cases of C3 type; and one case of A3 and C2 type of fracture. The mean surgical time was 93.1 minutes (range: 70–120 minutes). The mean radiological fracture union time was 13.1 weeks (range: 10–18 weeks). Shoulder function was excellent in 24 cases (82.7%) and good in remaining 5 cases (17.3%) on the UCLA score. Elbow function was excellent in 25 cases (86.2%) and good in 4 cases (13.8%) on mayo elbow performance score. 2 patients developed radial nerve palsy and translation was present in 4 patients.
Conclusion: In diaphyseal humerus fracture, MIPO gives good functional and cosmetic result and this should be considered as one of the good option in treatment of diaphyseal humerus fracture.