Parallax-free panoramic X-ray imaging combined with minimally invasive plate osteosynthesis for treating proximal humeral shaft fractures.

Background: The objective of this study was to evaluate the use of combined parallax-free panoramic X-ray imaging during surgery by enabling the mobile C-arm with minimally invasive plate osteosynthesis (MIPO) in the management of proximal humeral shaft fractures.

Aim: To evaluate parallax-free panoramic X-ray images during surgery.

Methods: A retrospective series of 17 proximal humeral shaft fractures were treated using combined parallax-free panoramic X-ray imaging during surgery by enabling the mobile C-arm with MIPO. The operating time and radiation exposure time were recorded, and early postoperative physical therapy and partial weight bearing were encouraged. Patients were followed at regular intervals and evaluated radiographically and clinically.

Results: The mean operating time and radiation time were 73 (range, 49-95) minutes and 57 (range: 36-98) seconds, respectively. No complications occurred during the operation. All fractures healed at an average of 16.9 (range: 15-23) weeks. The average Constant-Murley score for all the patients was 89.5 (range: 75-100) points. None of the patients showed symptoms of vascular or nerve damage or wound infection. Three months after the operation, none of the patients developed subacromial impingement syndrome. No loosening or fracture of the implants occurred. The frontal and lateral radiographs showed good alignment.

Conclusion: We consider that MIPO with combined parallax-free panoramic X-ray imaging during surgery is an efficient method for treating proximal humeral shaft fractures, and could significantly reduce operative morbidity as well as lower the rate of intra- and postoperative complications.