Evidence map›Paper›PMID 32929614›Full record

ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2021

Anterior minimally invasive plating osteosynthesis technique (MIPO) for humeral shaft fractures: an anatomical study of neuromuscular structures at risk.

Marcos Giordano, Vincenzo Giordano, Vinícius Schott Gameiro, William Belangero, Bruno Livani, Peter V Giannoudis, Christian Krettek

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Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. [Effectiveness comparison of two minimally invasive plate osteosynthesis techniques for proximal humeral shaft fractures].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2023
    Article
4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Marcos GiordanoServiço de Traumato-Ortopedia, Hospital de Força Aérea do Galeão, Rio de Janeiro, Brazil.
Vincenzo GiordanoServiço de Ortopedia e Traumatologia Prof. Nova Monteiro, Hospital Municipal Miguel Couto, Rua Mário Ribeiro 117/2º andar, Leblon, Rio de Janeiro, RJ, 22430-160, Brazil. v_giordano@me.com.ORCID http://orcid.org/0000-0002-4429-312X
Vinícius Schott GameiroDepartamento de Cirurgia, Universidade Federal Fluminense (UFF), Niterói, Brazil.
William BelangeroDepartamento de Ortopedia, Faculdade de Ciências Médicas, Universidade de Campinas (UNICAMP), Campinas, Brazil.
Bruno LivaniDepartamento de Ortopedia, Faculdade de Ciências Médicas, Universidade de Campinas (UNICAMP), Campinas, Brazil.
Peter V GiannoudisAcademic Department of Trauma and Orthopaedic Surgery, School of Medicine, University of Leeds, Leeds, UK.
Christian KrettekKlinik für Unfallchirurgie, Medizinische Hochschule Hannover (MHH), Hannover, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe aim of this study was to evaluate the neuromuscular structures at risk during modified anterior minimally invasive plating osteosynthesis technique (Belangero-Livani) for humeral shaft fractures.

methodsEight fresh-frozen human specimens ranging from 38 to 82 years old were used. Specimens were positioned supine with the shoulder in 70° abduction and the forearm in full supination. Anterior minimally invasive plating osteosynthesis technique according to Belangero-Livani technique was performed in each specimen. Under radioscopic control, the plate was introduced in retrograde fashion through the subbrachialis path. Anatomical structures were inspected and different anatomical parameters were measured after dissection at the end of the surgical procedures. Measurements were performed using a high digital caliper. Statistical analysis was performed using the Pearson's correlation coefficient test. A p value of < 0.05 was used to define statistical significance.

resultsThere were no macroscopic lesions of myotendinous or neurovascular structures in any specimen. The mean distance between the radial nerve to the distal lateral end of the plate was 8.63 mm (range 4.14-13.83 mm). The mean total length of the humerus was 328.59 mm. We found a significant direct correlation between the total length of the humerus and both specimen height and weight.

conclusionThe modified Belangero-Livani anterior MIPO technique for humeral shaft fractures performed in retrograde fashion is safe and useful, without major risk to the soft tissue of the anterior compartment of the arm, including the radial nerve in the lateral intermuscular septum. Intraoperative dissection, avoiding deep lateral retraction on the distal approach, minimizes the risk of radial nerve damage. Strict surgical planning and appreciation for the anatomic landmarks can reduce the risk of damage to neuromuscular structures. LEVEL OF EVIDENCE: Level IV; Case series with no comparison group; Treatment study.

Indexed as

Humeral FracturesMinimally Invasive Surgical ProceduresBone PlatesFracture Fixation, InternalHumansHumerusTreatment OutcomeCadaveric studyDiaphysisHumeral fracturesInternal fracture fixationMinimally invasive plate osteosynthesis

Identifiers

PMID32929614

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