Minimally invasive percutaneous plating of complex metaphyseal-diaphyseal proximal humeral fractures

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Background: Many anatomic, cadaver studies have shown safe anterior and anterolateral percutaneous plating of the humerus; however, there is paucity of information on this in clinical case series. The aim of the current study was to assess outcome of minimally invasive plate osteosynthesis in complex metaphyseal-diaphyseal humeral fractures. Methods: Eighteen patients with acute, complex, proximal humeral fractures with diaphyseal extension were operated on using a long proximal humeral plate through a percutaneous minimally invasive technique. Results: Union was obtained in all patients with good alignment and good shoulder and elbow function. The average time to union was 15 wk (range, 9-21 wk). Two patients developed postoperative radial nerve palsy that recovered after 3 wk in the first and 9 wk in the second patient. There were no obvious neurovascular injuries or major complications. Conclusions: Mini-invasive percutaneous plating of complex metaphyseal-diaphyseal humeral fractures is feasible and safe and has good clinical outcomes.