The authors describe for the first time ever a minimally invasive plate osteosythesis for the treatment of the humeral shatf fractures. After anatomic human cadaver's studies, it was identified three surgical approaches for plate percutaneous insertion on the anterior surface of the humerus without vascular and nervous injury. The proximal approach is between the biceps and deltoid muscles. The distal approach for medial third fractures is between the biceps brachialis and brachialis muscles. The plate is inserted from the proximal to distal direction. For distal fractures, the proximal approach is the same described by Krocher, with the plate inserted from distal to proximal and fixed on the anterior surface of the lateral column of the humerus. This method has been used since June/2001 mainly for the treatment of multiple trauma patients, allowing other surgical procedures, and it has been showed very efficient. The patient is operated in DHD without image intensifier or x ray apparatus. Until the moment, 22 patients have been treated without vascular or nervous complications.
Humeral fractures; Fracture fixation; Bone plates; Diaphysis
