Treatment of Proximal Humeral Fractures Using Minimally Invasive Plate Osteosynthesis

Background: Proximal humeral fracture (PHF) is a common orthopedic injury that constitutes 4% - 5% of all fractures. An appropriate treatment for PHF is very challenging. Minimally invasive surgery (MIS) techniques are presented to reduce soft tissue damage and save biological tissues at the fracture site. The current study aimed at investigating the clinical, functional, and the radiographic results, as well as complications of the surgical treatment of PHF with minimally invasive plate osteosynthesis (MIPO). Methods: 24 patients with proximal humeral fracture, classified according to Neer classification, aged over 18 years, from 2013 to 2014, with closed and displaced pattern underwent surgery by MIPO technique. In the follow-up period, patients were clinically evaluated using the criteria for the arm, shoulder, and hand disabilities (DASH score) and visual analogue scale (VAS). All complications related to the surgery and fracture healing were recorded. Results: Data regarding the 24 studied patients with themean age of 57.6±4.11 years were analyzed. In the current study, one patient presented superficial wound infection. Three patients had axillary nerve injury (12.5 %). In two cases subacromial impingement (SAI) due to greater tuberosity avulsion was observed. The motion range of forward flexion, abduction, and external rotation were 141 ± 39, 129±31, and 28±22 degrees, respectively. In the final visit, the averageDASH and VAS scores were 3.6±2.21 and 3.1±1, respectively. Conclusions: Considering the reasonable functional and radiological results, low pain intensity, and finally low incidence of complications after surgery, the MIPO technique can be properly employed to treat proximal humeral fractures.