Minimally invasive osteosynthesis of distal humerus fracture with commercially available pre-contoured plate using an anterolateral approach: a cadaveric study Distal humerus fracture anterolateral osteosynthesis
Main Article Content
http://orcid.org/0000-0001-8107-288X
Jaime Valencia, MD.
http://orcid.org/0000-0002-8499-9813
William Henry Márquez, MD.
http://orcid.org/0000-0002-8687-554X
Juan Carlos Jaramillo, MD.
http://orcid.org/0009-0008-1910-6952
Santiago Ordoñez, MD.
http://orcid.org/0000-0001-5659-1469
Francisco Javier Monsalve, MD.
http://orcid.org/0000-0002-9477-0203
Ana Milena Herrera, MD. Ph.D.
http://orcid.org/0000-0002-7382-5631
Abstract
Background: Minimally invasive plate osteosynthesis for the surgical treatment of distal diaphyseal humerus fractures represents an attractive option as it minimizes the extensive soft-tissue disruption associated with the posterior open approach. A minimally invasive plate osteosynthesis through an anteromedial has been proposed as an alternative; however, it could be technically challenging due to the closeness of the median and ulnar nerves and brachial artery.
Aims:This anatomical study aimed to determine the feasibility and safety of a minimally invasive plate osteosynthesis through an anterior approach and anterolateral fixation using a pre-contoured locking plate modified to adjust to the anatomical surface of the lateral column of the humerus.
Methods: Nine arms from five fresh cadavers were used to simulate the surgical procedure of minimally invasive plate osteosynthesis through an anterior approach performing anterolateral fixation using a molded commercially available locking plate on the lateral column of the humerus of the previously created distal diaphyseal humerus fracture. Assessed measurements were the interval from the distal part of the plate to the capitellum, the interval from the plate to the lateral cortex of the humerus, and the distance from the plate to the radial nerve.
Results: The most distal location of the plate is defined by palpating the most proximal edge of the capitellum. The mean distance from the distal part of the plate to the capitellum was 10.75 ± 0.9 mm, from the plate to the lateral cortex of the humerus was 5.25 ± 0.7 mm, and from the plate to the radial nerve was 10.9 ± 0.6 mm.
Conclusion: This anterior approach for a minimally invasive plate osteosynthesis with anterolateral fixation in distal diaphyseal humerus fractures allows better visualization of the fracture site with minimal soft tissue damage while protecting the radial neurovascular structures; careful dissection is crucial to reduce potential complications.
Article Details
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