Danger zones for the placement of locking screws in humeral diaphysis fracture osteosynthesis with Minimally Invasive Technique (MIPO)
Several recent articles have described the technique of minimally invasive plate osteosynthesis (MIPO) in the treatment of humeral shaft fractures using the anterior approach. Objective: to identify the danger zone for the placement of locking screws to avoid injury to the musculocutaneous nerve in...
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| Formato: | Artículo revista |
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Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2022
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| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/38964 |
| Aporte de: |
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I10-R327-article-38964 |
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ojs |
| institution |
Universidad Nacional de Córdoba |
| institution_str |
I-10 |
| repository_str |
R-327 |
| container_title_str |
Revista de la Facultad de Ciencias Médicas de Córdoba |
| format |
Artículo revista |
| topic |
osteosynthesis humerus locking screws osteosintesis humero tornillos bloqueo . |
| spellingShingle |
osteosynthesis humerus locking screws osteosintesis humero tornillos bloqueo . Sanchez Carpio , D Zeballos , L Simondi , N Danger zones for the placement of locking screws in humeral diaphysis fracture osteosynthesis with Minimally Invasive Technique (MIPO) |
| topic_facet |
osteosynthesis humerus locking screws osteosintesis humero tornillos bloqueo . |
| author |
Sanchez Carpio , D Zeballos , L Simondi , N |
| author_facet |
Sanchez Carpio , D Zeballos , L Simondi , N |
| author_sort |
Sanchez Carpio , D |
| title |
Danger zones for the placement of locking screws in humeral diaphysis fracture osteosynthesis with Minimally Invasive Technique (MIPO) |
| title_short |
Danger zones for the placement of locking screws in humeral diaphysis fracture osteosynthesis with Minimally Invasive Technique (MIPO) |
| title_full |
Danger zones for the placement of locking screws in humeral diaphysis fracture osteosynthesis with Minimally Invasive Technique (MIPO) |
| title_fullStr |
Danger zones for the placement of locking screws in humeral diaphysis fracture osteosynthesis with Minimally Invasive Technique (MIPO) |
| title_full_unstemmed |
Danger zones for the placement of locking screws in humeral diaphysis fracture osteosynthesis with Minimally Invasive Technique (MIPO) |
| title_sort |
danger zones for the placement of locking screws in humeral diaphysis fracture osteosynthesis with minimally invasive technique (mipo) |
| description |
Several recent articles have described the technique of minimally invasive plate osteosynthesis (MIPO) in the treatment of humeral shaft fractures using the anterior approach. Objective: to identify the danger zone for the placement of locking screws to avoid injury to the musculocutaneous nerve in the anterior compartment and injury to the radial nerve in the posterior compartment of the humerus in relation to humeral length.
Ten cadaveric arms were fixed with locking compression plate (LCP) with MIPO technique. Two locking screws were fixed at each end using the open technique; the remaining six screws inserted percutaneously. Both anterior and posterior were dissected to identify lesions of the musculocutaneous nerve and the radial nerve. Humeral length with a single palpable bony landmark was measured from the posterior tip of the acromion process to the lateral epicondyle. Damage or direct contact of the locking screws with the musculocutaneous or radial nerve was recorded, and the distance between the screws and the radial nerve was also measured.
The mean humeral length was 29.71 cm (99% confidence interval (CI): 28.54-30.86). The area of fixation of the first to the tenth locking screw was 5.46 and 21.06 cm, respectively, measured from the lateral epicondyle. On the anterior aspect, the fixation zone causing musculocutaneous nerve injury averaged between 5.46-12.68 cm from the lateral epicondyle. The first 4 screws were the most risky and had direct contact with the musculocutaneous nerve. On the posterior face, the fixation zone that caused radial nerve injury averaged between 10.8-17.59 cm from the lateral epicondyle and most of the dangerous screws that penetrated or touched the radial nerve were in the sixth and third holes. seventh, which are at 14.03-15.8 cm. The distances between the screws and radial ribs.
The danger zone for the musculocutaneous and radial nerves could be determined. Since the area of radial nerve injury shows great variation, this procedure should only be performed by experienced surgeons. |
| publisher |
Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología |
| publishDate |
2022 |
| url |
https://revistas.unc.edu.ar/index.php/med/article/view/38964 |
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| spelling |
I10-R327-article-389642024-04-15T16:14:45Z Danger zones for the placement of locking screws in humeral diaphysis fracture osteosynthesis with Minimally Invasive Technique (MIPO) Zonas de peligro para la colocación de tornillos de bloqueo en osteosíntesis de fractura de diáfisis humeral con Técnica Mínimamente Invasiva (MIPO) . Sanchez Carpio , D Zeballos , L Simondi , N osteosynthesis humerus locking screws osteosintesis humero tornillos bloqueo . Several recent articles have described the technique of minimally invasive plate osteosynthesis (MIPO) in the treatment of humeral shaft fractures using the anterior approach. Objective: to identify the danger zone for the placement of locking screws to avoid injury to the musculocutaneous nerve in the anterior compartment and injury to the radial nerve in the posterior compartment of the humerus in relation to humeral length. Ten cadaveric arms were fixed with locking compression plate (LCP) with MIPO technique. Two locking screws were fixed at each end using the open technique; the remaining six screws inserted percutaneously. Both anterior and posterior were dissected to identify lesions of the musculocutaneous nerve and the radial nerve. Humeral length with a single palpable bony landmark was measured from the posterior tip of the acromion process to the lateral epicondyle. Damage or direct contact of the locking screws with the musculocutaneous or radial nerve was recorded, and the distance between the screws and the radial nerve was also measured. The mean humeral length was 29.71 cm (99% confidence interval (CI): 28.54-30.86). The area of fixation of the first to the tenth locking screw was 5.46 and 21.06 cm, respectively, measured from the lateral epicondyle. On the anterior aspect, the fixation zone causing musculocutaneous nerve injury averaged between 5.46-12.68 cm from the lateral epicondyle. The first 4 screws were the most risky and had direct contact with the musculocutaneous nerve. On the posterior face, the fixation zone that caused radial nerve injury averaged between 10.8-17.59 cm from the lateral epicondyle and most of the dangerous screws that penetrated or touched the radial nerve were in the sixth and third holes. seventh, which are at 14.03-15.8 cm. The distances between the screws and radial ribs. The danger zone for the musculocutaneous and radial nerves could be determined. Since the area of radial nerve injury shows great variation, this procedure should only be performed by experienced surgeons. Varios articulos recientes han descrito la técnica de osteosíntesis con placa mínimamente invasiva (MIPO) en el tratamiento de las fracturas de la diáfisis humeral mediante el abordaje anterior. Objetivo: identificar la zona de peligro para la colocación de tornillos de bloqueo para evitar la lesión del nervio musculocutáneo en el compartimento anterior y la lesión del nervio radial en el compartimento posterior del húmero en relación con la longitud humeral. Diez brazos de cadáveres se fijaron con placa de compresión de bloqueo (LCP) con técnica MIPO. Se fijaron dos tornillos de bloqueo en cada extremo mediante la técnica abierta; los restantes seis tornillos se insertaron percutáneamente. Se disecaron tanto anterior como posterior para identificar lesiones del nervio musculocutáneo y del nervio radial. La longitud humeral con un punto simple de referencia óseo palpable se midió desde la punta posterior del proceso del acromion hasta el epicóndilo lateral. Se registró el daño o contacto directo de los tornillos de bloqueo con el nervio musculocutáneo o radial y además se midió la distancia entre los tornillos y el nervio radial. La longitud humeral media fue de 29,71 cm (intervalo de confianza (IC) del 99%: 28,54-30,86). La zona de fijación del primero al décimo tornillo de bloqueo fue de 5,46 a 21,06 cm respectivamente , medido desde el epicóndilo lateral. En la cara anterior, la zona de fijación que provoca lesión del nervio musculocutáneo promedió entre 5,46-12,68 cm desde el epicóndilo lateral . Los primeros 4 tornillos fueron los mas riesgosos y tenían contacto directo con el nervio musculocutáneo. En la cara posterior la zona de fijación que provoco lesión del nervio radial promedióentre los 10,8-17,59 cm desde el epicondilo lateral y la mayor parte de los tornillos peligrosos que penetraron o tocaron el nervio radial estaban en los orificios sexto y séptimo, que se encuentran a 14,03-15,8 cm. Se midieron las distancias entre los tornillos y los nervios radiales. Se pudo determinar la zona de peligro para los nervios musculocutáneo y radial. Dado que la zona con lesiones del nervio radial muestra una gran variación, este procedimiento solo debe ser realizado por cirujanos experimentados. . Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2022-10-26 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion texto texto . https://revistas.unc.edu.ar/index.php/med/article/view/38964 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 79 No. Suplemento JIC XXIII (2022): Suplemento JIC XXIII Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 79 Núm. Suplemento JIC XXIII (2022): Suplemento JIC XXIII Revista da Faculdade de Ciências Médicas de Córdoba; v. 79 n. Suplemento JIC XXIII (2022): Suplemento JIC XXIII 1853-0605 0014-6722 http://creativecommons.org/licenses/by-nc/4.0 |