Anterior minimally invasive plating osteosynthesis using reversed proximal humeral internal locking system plate for distal humeral shaft fractures

Eur J Orthop Surg Traumatol. 2020 Dec;30(8):1515-1521. doi: 10.1007/s00590-020-02708-0. Epub 2020 May 28.


Objective: To describe the surgical application of anterior minimally invasive plating osteosynthesis (MIPO) using reversed proximal humerus internal locking system (PHILOS) plate for multifragmentary distal humeral shaft fractures.

Methods: Twelve patients with distal humeral shaft fractures (type 12B, n = 6 and type 12C, n = 6) were operated on by anterior MIPO and reversed PHILOS plate fixation. The amount of intact bone in the distal fragment was measured by fracture-to-coronoid distance (FCD). Data of the postoperative alignment, complications, union time, and clinical outcomes were collected.

Results: The mean time for fractures to unite in all patients was 14.8 weeks (range 12-22). There was no perioperative complication. The mean FCD was 4.8 cm (range 2.1-8.1). The mean coronal angulation was 3.4° (range 0-9), and the mean sagittal angulation was 1° (range 0-5). All patients had excellent UCLA shoulder score and MEP score results, and the mean range of elbow motion was 140° (range 130-145).

Conclusion: Anterior MIPO using reversed PHILOS plate is safe and effective for multifragmentary fractures of the distal humeral shaft even in a fracture with a length of intact bone above the coronoid fossa of only 2 cm.

Keywords: Anterior MIPO; Distal humeral shaft fracture; Reversed PHILOS.

MeSH terms

  • Bone Plates
  • Fracture Fixation, Internal
  • Humans
  • Humeral Fractures* / diagnostic imaging
  • Humeral Fractures* / surgery
  • Humerus
  • Minimally Invasive Surgical Procedures
  • Shoulder*
  • Treatment Outcome