Functional outcome of minimally invasive plate osteosynthesis technique in shaft of humerus fractures: a prospective cohort study

Authors

  • Chahan M. Pandya Department of Orthopaedics, Zydus Medical College and Hospital, Dahod, Gujarat, India
  • Vishal M. Dindod Department of Orthopaedics, Zydus Medical College and Hospital, Dahod, Gujarat, India
  • Pratik S. Bhabhor Department of Orthopaedics, Zydus Medical College and Hospital, Dahod, Gujarat, India
  • Nilay P. Kumar Department of Orthopaedics, Zydus Medical College and Hospital, Dahod, Gujarat, India
  • Devesh S. Kumar Department of Orthopaedics, Zydus Medical College and Hospital, Dahod, Gujarat, India
  • Saurav K. Padval Department of Orthopaedics, Zydus Medical College and Hospital, Dahod, Gujarat, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20262908

Keywords:

Humeral shaft fracture, Minimally invasive plate osteosynthesis, MIPO, Anterior bridge plating, Functional outcome, Radiological union

Abstract

Background: Humeral shaft fractures require restoration of alignment while preserving soft tissue. Minimally invasive plate osteosynthesis (MIPO) with anterior bridge plating aims to achieve stable fixation with minimal soft‑tissue disruption. This study evaluated the functional, clinical, and radiological outcomes of anterior bridge plating using MIPO for humeral shaft fractures.

Methods: Prospective observational cohort study at the Department of Orthopaedics, Zydus Medical College and Hospital, Dahod, Gujarat, from October 2023 to December 2025. Twenty‑four patients (18-50 years) with closed or Gustilo grade I open humeral shaft fractures underwent MIPO using locking compression plates (LCP) via an anterior brachialis‑splitting approach. Outcomes assessed were Constant‑Murley score (CMS) and Mayo elbow performance score (MEPS) at 3 weeks, 6 weeks, 3 months, 6 months, and 12 months, along with radiological union time, operative time, blood loss, and complications.

Results: Mean age was 35.2±9.4 years; 91.7% were male. AO type 12A fractures comprised 87.5% of cases. Mean operative time was 72.5±7.7 minutes and mean blood loss 119±14 mL. Mean radiological union time was 14.2±2.7 weeks. At final follow‑up mean CMS was 90.0±4.0 and mean MEPS 94.1±3.8; 91.7% of patients achieved excellent or good functional outcomes. Three complications occurred: one delayed union, one nonunion, and one deep infection. No iatrogenic radial nerve palsy was observed.

Conclusions: Anterior bridge‑plate MIPO for humeral shaft fractures is safe and reproducible, yielding high rates of union and excellent functional outcomes with a low complication profile. Its minimal soft‑tissue disruption makes it well suited to resource‑limited settings.

References

Mahabier KC, Vogels LMM, Punt BJ, Roukema GR, Patka P, Van Lieshout EMM. Humeral shaft fractures: retrospective results of non-operative and operative treatment of 186 patients. Injury. 2013;44(4):427-30.

Keshav K, Baghel A, Kumar V, Neradi D, Kaustubh K, Mishra P. Is minimally invasive plating osteosynthesis better than conventional open plating for humeral shaft fractures? A systematic review and meta-analysis. Indian J Orthop. 2021;55(2):283-303.

Apivatthakakul T, Arpornchayanon O, Bavornratanavech S. Minimally invasive plate osteosynthesis (MIPO) of the humeral shaft fracture. Injury. 2005;36(4):530-8.

Apivatthakakul T, Patiyasikan S, Luevitoonvechkit S. Danger zone for locking screw placement in minimally invasive plate osteosynthesis (MIPO) of humeral shaft fractures: a cadaveric study. Injury. 2010;41(2):169-72.

Sharma A, Sharma G, Bidoliya V, Nagina K. Evaluation of results of minimally invasive plate osteosynthesis for humeral shaft fractures: a study involving 40 patients. Surg Rev Int J Surg Trauma Orthop. 2020;6(1):27-34.

Dave H, Modi N, Pawar E, Gavhale S, Topno R, Shet V. Radiological and functional outcomes of anterior bridge plating with minimally invasive plate osteosynthesis technique for humerus diaphyseal fractures in adults. Int J Res Orthop. 2023;9(5):1000-8.

Zhiquan A, Bingfang Z, Yeming W, Chi Z, Peiyan H. Minimally invasive plating osteosynthesis (MIPO) of middle and distal third humeral shaft fractures. J Orthop Trauma. 2007;21(9):628-33.

Concha JM, Sandoval A, Streubel PN. Minimally invasive plate osteosynthesis for humeral shaft fractures: are results reproducible? Int Orthop. 2010;34(8):1297-305.

Jiang R, Luo CF, Zeng BF, Mei GH. Minimally invasive plating for complex humeral shaft fractures. Arch Orthop Trauma Surg. 2007;127(7):531-6.

Mahajan AS, Kim YG, Kim JH, D'Sa P, Lakhani A, Ok HS. Is anterior bridge plating for mid-shaft humeral fractures a suitable option for patients predominantly involved in overhead activities? Clin Orthop Surg. 2016;8(4):358-66.

Wang C, Li J, Li Y, Dai G, Wang M. Is minimally invasive plating osteosynthesis for humeral shaft fractures advantageous compared with the conventional open technique? J Shoulder Elbow Surg. 2015;24(11):1741-8.

Zhao JG, Wang J, Meng XH, Zeng XT, Kan SL. Surgical interventions to treat humerus shaft fractures: a network meta-analysis of randomized controlled trials. PLoS One. 2017;12(3):e0173634.

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Published

2026-08-25

How to Cite

Pandya, C. M., Dindod, V. M., Bhabhor, P. S., Kumar, N. P., Kumar, D. S., & Padval, S. K. (2026). Functional outcome of minimally invasive plate osteosynthesis technique in shaft of humerus fractures: a prospective cohort study. International Journal of Research in Orthopaedics, 12(5), 1389–1393. https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20262908

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Original Research Articles