Lateral Minimally Invasive Plate Osteosynthesis of Proximal Metadiaphyseal Humeral Fractures: A Case Series and Review of the Literature

Humeral shaft fractures are common, but proximal metadiaphyseal fractures are unusual and represent challenging injuries.Their treatment is still controversial and debatable.Lateral minimally invasive osteosynthesis (MIPO) represents an alternative treatment for those fractures, but there is still a lack of studies describing this technique.We retrospectively reviewed six patients with proximal metadiaphyseal humeral fractures treated with lateral MIPO.All the patients reached consolidation.We had one case of postoperative radial neuropraxia that entirely resolved with time, and there was no other complication.We reviewed and summarized the available literature, and our outcomes were similar to those described.The mean shoulder ROM was 143º ± 12,4º of abduction; 145º ± 9,1º of forward elevation; 33,8º ± 4,8º of external rotation; most patients reached L1 level with internal rotation, with no statistically significant difference between the affected and non-affected arm.The mean Constant score was 88 ± 5,4; the mean Q-DASH score was 8 ± 1,3; and the mean UCLA score was 28,8 ± 2,6º.The lateral MIPO approach permits a good shoulder function and a high union rate.Radial neuropraxia is the most common complication described in the literature and usually entirely resolves with time.Orthopaedic and trauma surgeons dedicated to shoulder injuries should know different approaches and fixation methods.MIPO should also be in their arsenal, with the lateral approach advantageous in proximal metadyaphiseal fractures and a reproductive technique.