MIPO with helical plate for segmental humeral fracture in an elderly adult
Keywords:
humeral fractures, internal fracture fixation, treatment outcome, older adultsAbstract
Introduction: Segmental diaphyseal humeral fractures are rare injury patterns caused by high-energy trauma, impacting autonomy and quality of life, and potentially life-threatening in older adults. Their treatment is controversial and challenging.
Objective: To validate the efficacy of the minimally invasive plate osteosynthesis technique with helical molding of the proximal humeral internal locking system in the repair of segmental humeral fractures in the elderly.
Case report: We report the case of a 76-year-old man with a segmental diaphyseal fracture of the right humerus, treated with the minimally invasive plate osteosynthesis technique and a proximal humeral internal locking system. The patient's outcome was satisfactory after a 16-month follow-up.
Conclusions: The minimally invasive plate osteosynthesis technique using the proximal humeral helical plate internal locking system is an effective surgical option for the repair of segmental humeral fractures in older adults.
Downloads
References
1. Viollaz GM, Tedeschi A, Calo L, Muratore ÁJ, Durán R, Teruya G, et al. Surgical treatment in Maresca type A2 bifocal humeral fractures. Rev Asoc Argent Ortop Traumatol. 2023;88(4):409-18. DOI: https://doi.org/10.15417/issn.1852-7434.2023.88.4.1580
2. Scaglione M, Casella F, Ipponi E, Agretti F, Polloni S, Giuntoli M, et al. Multifocal humeral fractures: clinical results, functional outcomes and flowchart of surgical treatment. Strategies Trauma Limb Reconstr. 2022;17(2):81-7. DOI: https://doi.org/10.5005/jp-journals-10080-1559
3. Maes V, Putzeys G. One-year follow-up after treatment of proximal and/or middle one-third humeral shaft fractures with a helical plate: healing rates, complications and functional outcome measures. BMC Musculoskelet Disord. 2021;(22):890. DOI: https://doi.org/10.1186/s12891-021-04774-9
4. Deligne L, Sousa J, Carvalho L. Locking plates versus locking intramedullary nails fixation for multifocal humeral fractures: a systematic review and meta-analysis. PROSPERO. 2024 [acceso 13/02/2025]. Disponible en: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024492231
5. Meinberg E, Agel J, Roberts C, Karam M, Kellam J. Fracture and dislocation classification compendium-2018. J Orthop Trauma. 2018;32 supl 1:S1-S170. DOI: https://doi.org/10.1097/bot.0000000000001063
6. Vargas RE, Zavaleta RL, Lozano KY. MIPO con placa helicoidal en fractura de húmero. Rev Cub Ortop Traumatol. 2022 [acceso 22/02/2025];36(4). DOI: https://revortopedia.sld.cu/index.php/revortopedia/article/view/499
7. Da Silva T, Rummel F, Knop C. Comparing iatrogenic radial nerve lesions in humeral shaft fractures treated with helical or straight PHILOS plates: a 10-year retrospective cohort study of 62 cases. Arch Orthop Trauma Surg. 2020;140(12):1931-7. DOI: https://doi.org/10.1007/s00402-020-03438-y
8. Başal Ö, Erdağ Y, Pehlivanoğlu T, Akar A, Dinçer R, Aydogan M. Minimally invasive plate osteosynthesis for segmental humerus fractures with a helical plate. Which distal fixation -the anterior or lateral- is superior? J Health Sci Med/JHSM. 2022;5(5):1225-31. DOI: https://doi.org/10.32322/jhsm.1109367
9. Touloupakis G, Ruberto E, Pernigotti E, Theodorakis E, Gilli A, Messori M, et al. Helical PHILOS plating in shaft humeral fractures with proximal extension: a safe choice using an anterior approach. Clin Ter. 2024;175(5):318-22. DOI: https://doi.org/10.7417/ct.2024.5136
10. Seyfettinoğlu F, Oğur HU, Tuhanioğlu Ü, Çiçek H, Kapukaya A. Management of AO type 12C humerus proximal metadiaphyseal fractures with minimally invasive plate osteosynthesis in geriatric patients. Clin Interv Aging. 2018;13:1003-10. DOI: https://doi.org/10.2147/cia.s162356
11. Ortega-Yago A, Balfagón-Ferrer A, Barrés-Carsí M, Bas-Hermida JL. Treating multifocal humerus fractures: A comparison between the mipo technique and intramedullary nailing. Injury. 2022;53(10):3332-8. DOI: https://doi.org/10.1016/j.injury.2022.07.049
12. Da Silva T, Rummel F, Knop C, Merkle T. Shoulder function after helical long PHILOS plate. Eur J Orthop Surg Traumatol. 2021;31(7):1463-9. DOI: https://doi.org/10.1007/s00590-021-02908-2
13. Nicolaci G, Lollino N. How to treat proximal and middle one-third humeral shaft fractures: The role of helical plates. Surg Techn Develop. 2021;10(1):9175. DOI: https://doi.org/10.4081/std.2021.9175
14. Dauwe J, Grechenig P, Unterfrauner I, Schwarz A, Weiglein A, Hohenberger G. Axillary nerve elongation in humeral fracture plating: A cadaveric study for comparison between straight and helical Philos plates. J Orthop. 2020;19:233-6. DOI: https://doi.org/10.1016/j.jor.2020.02.009
15. Zamboni C, Carmo B, Moraes L, Hungría J, Mercadante M, Fucs P. A practical guide for the use of contour locking plates for the repair of humeral diaphyseal fractures with proximal extension. Injury. 2019;50(12):2247-51. DOI: https://doi.org/10.1016/j.injury.2019.09.026
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Renán Estuardo Vargas Morales
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
