January – February 2020/ Vol 6/ Issue 1 Print ISSN: 2456-9518, Online ISSN: 2455-5436 Original Research Article Surgical Update: International Journal of Surgery & Orthopedics Available online at: www.medresearch.in 27 | Page Evaluation of results of minimally invasive plate osteosynthesis for humeral shaft fractures. A study involving 40 patients Sharma A. 1 , Sharma G. 2 , Bidoliya V. 3 , Nagina K. 4 1 Dr. Ashwini Sharma, Associate Professor, 2 Dr. Gourav Sharma, Assistant Professor, 3 Dr. Vinaydeep Bidoliya, Senior Resident, 4 Dr. Kirtiraj Nagina, Senior Resident; all authors are affiliated with Department of Orthopaedics, Chirayu Medical College hospital, Bhopal, Madhya Pradesh, India. Corresponding Author: Dr. Gourav Sharma, Assistant Professor, Department of Orthopaedics, Chirayu Medical College Hospital, Bhopal, Madhya Pradesh, India. Email: gourav.sharma842@gmail.com ……………………………………………………………………………………………………………………………………... Abstract Introduction: Fracture of humeral shaft account for roughly 3% of all fractures. Previously, non-operative treatment has been accepted modality of treatment. Three main operative techniques are in vogue for treating displaced humeral shaft fractures namely intramedullary nailing, conventional plating osteosynthesis (CPO) and minimally invasive plate osteosynthesis (MIPO). Material and Methods: 40 fractures of humerus shaft were treated with MIPO technique, in a prospective study between December 2015 and September 2017 at our institute. The cases were followed up for a minimum period of 2 years. Results: The average age was 41 years (23-71 years). Twenty-three (57.5%) were males and 17 (42.5 %) females. Twenty- nine cases (72.5%) had injury in their dominant arm. The mean surgical time was 45.5 minutes and the mean radiation exposure was for 85.3 seconds. The mean follow-up of our cases was 33 months. Conclusion: MIPO is a better choice for treating humeral shaft fractures than CPO, though there is no significant difference between MIPO and CPO in terms of operative time, fracture union rate, and fracture union time. Keywords: CPO- Conventional plate osteosynthesis, MIPO-minimally invasive plate osteosynthesis, humerus shaft fracture ……………………………………………………………………………………………………………………………………... Introduction Fractures of humeral shaft account for roughly 3% of all fractures [1-3]. Previously, non-operative treatment has been accepted modality of treatment. Non operative treatment includes POP-u- cast and hanging cast. Sarmiento [4] popularized functional bracing of humeral shaft fractures to mitigate stiffness caused by cast treatment. However, a high rate of nonunion up to 10-40% was reported in humeral shaft fracture patients with nonoperative treatment. Nowadays treatment of humeral shaft fractures continues to generate controversy in orthopaedic community. Biber et al [5] opined that there is still no gold standard for the treatment of humeral shaft fractures and there is currently insufficient evidence for a clear superiority of either of the methods. Three main operative techniques are in vogue for treating displaced humeral shaft fractures namely intramedullary nailing, conventional plating osteosynthesis (CPO) and Manuscript Received: 26 th October 2019 Reviewed: 6 th November 2019 Author Corrected: 14 th November 2019 Accepted for Publication: 18 th November 2019 minimaslly invasive plate osteosynthesis (MIPO). Intramedullary nail and plate are the conventionally used surgical methods. Intramedullary nailing of humerus has its set of problems as long learning curve, shoulder stiffness, iatrogenic communition. Currently, open reduction and plate fixation remains to be the golden standard for humeral shaft fractures [6,7]. CPO has also got its own disadvantages such as surgical site infection, radial nerve palsy and extensive soft tissue dissection. Recently, minimally invasive plate osteosynthesis (MIPO) techniques with encouraging results in humeral shaft fracture patients have been reported [8-11]. MIPO not only carries advantage of smaller incisions but also eliminates disadvantage of shoulder stiffness as caused by IMN at the site of insertion. It seems to imply that MIPO is superior to conventional plate osteosynthesis (CPO).