ArticleJournal of orthopaedic surgery and research2026
MIPO versus ORIF with long proximal humerus locking plate for metadiaphyseal proximal humeral fracture.
Article in Journal of orthopaedic surgery and research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThis study aimed to compare ORIF (open reduction internal fixation) and MIPO (minimal invasive plate osteosynthesis) using long PHLP (proximal humerus locking plate) in treating metadiaphyseal proximal humeral fractures regarding time to union, complications, and clinical outcomes.
methodsThis retrospective study was conducted at a single-center Level 1 trauma facility. The study population consisted of patients who underwent long PHLP fixation for metadiaphyseal proximal humeral fractures and completed a minimum follow-up of 1 year. Patients with additional injuries in the same extremity, those treated with implants other than long PHLP, or those managed with surgical techniques other than MIPO or ORIF were excluded. The cohort was divided into two groups: MIPO (32 patients) and ORIF (29 patients). The groups were compared with respect to demographic characteristics (age, sex, mechanism of trauma), radiological outcomes (time to union), and clinical outcomes, including the Disabilities of the Arm, Shoulder and Hand (DASH) score, Constant-Murley score, and complication rates.
resultsThe mean age was 54.96 (SD 17.1, range 24-85) in the MIPO group and 54.55 (SD 15.03, range 22-84) in the ORIF group. The MIPO group (n = 32) had a significantly shorter mean time to union than the ORIF group (n = 29) [13.8 ± 3.0 vs. 17.3 ± 5.1 weeks; p = 0.003]. At 1 year, DASH scores were lower in the MIPO group [8.6 ± 7.1 vs. 12.8 ± 8.8; p = 0.044]. Constant-Murley scores showed no significant difference between groups [87.8 ± 6.2 vs. 84.5 ± 9.0; p = 0.094]. In the MIPO group, 1 (3.1%) patient had radial nerve impairment and 1 (3.1%) patient had subacromial impingement; in the ORIF group, 1 (3.4%) patient had radial nerve impairment and 2 (6.9%) patients had nonunion.
conclusionIn metadiaphyseal proximal humeral fractures, minimally invasive plate osteosynthesis using a long proximal humeral locking plate was associated with a shorter radiographic time to union than open reduction and internal fixation, although this finding should be interpreted in the context of the different radiographic union criteria applied in the two groups. LEVEL OF EVIDENCE: III.
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