Minimally invasive plate osteosynthesis with locking plate for metastatic humeral fractures

J Orthop Sci. 2022 Nov;27(6):1309-1314. doi: 10.1016/j.jos.2021.07.027. Epub 2021 Sep 25.

Abstract

Background: Limited reports have examined the outcomes and complications of minimally invasive plate osteosynthesis (MIPO) with a locking plate (LP) in metastatic humeral fractures. Therefore, this study aimed to evaluate the effectiveness of MIPO in the treatment of metastatic humeral fractures.

Methods: Patients who underwent MIPO for metastatic humeral fractures were included in this study. Data on patient demographics, new Katagiri score, operative time, amount of blood loss, bone union rate, range of motion (ROM) of the shoulder and elbow, and perioperative complications were obtained.

Results: Twelve patients (seven men and five women) with 14 fractures were included in this study. The median operative time was 92.6 ± 28.9 min (range, 57-175 min) and the median amount of intraoperative blood loss was 106.1 ± 109.5 g (range, 10-330 g). No patient required surgery-related transfusion. The median duration of acquisition of active elbow ROM of>100° and active shoulder flexion of >90° were 8.9 ± 6.6 days (range, 1-30 days) and 17.5 ± 13.0 days (range, 6-47 days), respectively. The mean follow-up period was 10.0 ± 9.0 months (range, 1-33 months). There were no complications, and no patient required any further surgery for the affected humerus until death.

Conclusion: MIPO using an LP provided acceptable functional outcomes in advanced-stage cancer patients with metastatic humeral fractures during their limited lifetime.

MeSH terms

  • Bone Plates
  • Female
  • Fracture Fixation, Internal
  • Humans
  • Humeral Fractures* / diagnostic imaging
  • Humeral Fractures* / etiology
  • Humeral Fractures* / surgery
  • Male
  • Minimally Invasive Surgical Procedures / adverse effects
  • Neoplasms*
  • Treatment Outcome