Abstract
Introduction and objective
Proximal humerus fractures with metaphysodiaphyseal extension represent a challenge
for the orthopedic surgeon due to their reduced incidence and the difficulty in the
treatment decision. These can be treated with an intramedullary nail or using the
MIPO technique, associating different advantages and complications depending on the
procedure. The objective of this study was to compare metaphyseal-diaphyseal fractures
of the humerus treated with antegrade intramedullary nailing and those operated using
the MIPO technique to see if there were significant differences in terms of functional,
clinical, and radiological results.
Material and methods
retrospective, analytical and unicentric review of 29 patients with proximal fracture
with metaphyseal-diaphyseal extension treated by MIPO technique and 33 patients surgically
treated by antegrade intramedullary nailing (IMN) in our hospital from 2014 to 2020.
Demographic, functional, radiographic and clinical data were obtained..
Results
No significant differences were observed between both groups in terms of fracture
mechanism (p=0.34), fracture type (p=0.13) or Maresca classification (p=0.32). Surgical
time was significantly shorter in the IMN group compared to the MIPO technique (p=0.014).
No significant difference was observed regarding the need for blood transfusion (p=0.32).
The mean consolidation in the MIPO group was 21 weeks compared to 21 weeks in the
IMN, with no significant differences between both groups (p= 0.88). No significant
differences were observed between CONSTANT test at one year in the MIPO group versus
the IMN group (p=0.79), nor in radial nerve palsies (p=0.28).
Conclusions
Proximal fractures with metaphyseal-diaphyseal extension are a challenge for the orthopedic
surgeon due to the infrequency, the complexity of these fractures and the fact that
there is no established consensus on the ideal treatment for this type of injury.
Both the MIPO technique with the Philos plate and the intramedullary nail are valid
options for the treatment of these fractures, with no differences observed in terms
of fracture consolidation time or in terms of functional results.
Keywords
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Article info
Publication history
Published online: August 01, 2022
Accepted:
July 29,
2022
Identification
Copyright
© 2022 Elsevier Ltd. All rights reserved.
