Functional outcome of minimally invasive plate osteosynthesis technique in shaft of humerus fractures: a prospective cohort study

Abstract

Background: Humeral shaft fractures require restoration of alignment while preserving soft tissue. Minimally invasive plate osteosynthesis (MIPO) with anterior bridge plating aims to achieve stable fixation with minimal soft‑tissue disruption. This study evaluated the functional, clinical, and radiological outcomes of anterior bridge plating using MIPO for humeral shaft fractures. Methods: Prospective observational cohort study at the Department of Orthopaedics, Zydus Medical College and Hospital, Dahod, Gujarat, from October 2023 to December 2025. Twenty‑four patients (18-50 years) with closed or Gustilo grade I open humeral shaft fractures underwent MIPO using locking compression plates (LCP) via an anterior brachialis‑splitting approach. Outcomes assessed were Constant‑Murley score (CMS) and Mayo elbow performance score (MEPS) at 3 weeks, 6 weeks, 3 months, 6 months, and 12 months, along with radiological union time, operative time, blood loss, and complications. Results: Mean age was 35.2±9.4 years; 91.7% were male. AO type 12A fractures comprised 87.5% of cases. Mean operative time was 72.5±7.7 minutes and mean blood loss 119±14 mL. Mean radiological union time was 14.2±2.7 weeks. At final follow‑up mean CMS was 90.0±4.0 and mean MEPS 94.1±3.8; 91.7% of patients achieved excellent or good functional outcomes. Three complications occurred: one delayed union, one nonunion, and one deep infection. No iatrogenic radial nerve palsy was observed. Conclusions: Anterior bridge‑plate MIPO for humeral shaft fractures is safe and reproducible, yielding high rates of union and excellent functional outcomes with a low complication profile. Its minimal soft‑tissue disruption makes it well suited to resource‑limited settings.