{
    "abstract": "To assess whether patients treated with a Minimally Invasive Rotator-Interval Technique (MIR-IT) versus the traditional technique of splitting the rotator cuff (RTCS) for intramedullary nailing of humeral shaft fractures resulted in comparable post-operative clinical and patient-reported outcomes (PROM).\nDesign: Retrospective Cohort Study.\nLevel 1 Trauma Center.\nPatients >18yo with humeral shaft fractures (AO/OTA 12A-C) treated with IMN between 2015 and 2022.\nThe primary outcome was differences in PROMs (ASES, Quick DASH, and Oxford Shoulder Score) between the MIR-IT and RTCS techniques. Secondary outcome measures included differences in rates of nonunion, superficial and deep surgical infections, wound dehiscence and iatrogenic nerve palsy between the two techniques.\nSeventy-one patients underwent humeral IMN (MIR-IT - 39; RTCS - 32). Fifty-five patients (MIR-IT- 30; RTCS-25) had radiographic and clinical follow up to union. Mean follow up was 7.5 months (range: 3.1-16.8 months). Patients did not vary significantly with regards to age (MIR-IT: 54.4 \u00b1 22.4; RTCS: 55.1 \u00b1 18.5 years, p=0.896), and gender (Males- MIR-IT: 46.7%, RTCS: 44%, p=0.843). There were no significant differences in nonunion (7.4% vs 4.0% p=1.0), superficial infection (3.6% vs 4% p=1.0) or iatrogenic nerve palsy (3.6% vs 4.0% p=1.0) between the MIR-IT and RTCS groups. There were no deep infections or wound dehiscences in either group. Forty-two patients had PROMs (MIR-IT -21; RTCS -21). Average time to PROMs collection was 35.7 months (MIR-IT: 34.2 months, RTCS: 37.1 months, p=0.682). There were significantly better ASES scores (82.7 vs 71.6 p=.015), Quick DASH scores (9.7 vs 21.0 p=.011) and Oxford Shoulder Scores (39.3 vs 33.9 p=.042) amongst patients treated with the MIR-IT.\nHumeral IMN utilizing the MIR-IT resulted in better shoulder PROMs compared to the RTCS technique, with similarly low surgical complication rates.\nTherapeutic Level II.",
    "authors": [
        {
            "affiliation": "Department of Orthopaedics, University of South Florida.",
            "firstname": "Lazaro",
            "initials": "L",
            "lastname": "Mesa"
        },
        {
            "affiliation": "Department of Orthopaedics, University of South Florida.",
            "firstname": "Christian M",
            "initials": "CM",
            "lastname": "Schmidt"
        },
        {
            "affiliation": "Department of Orthopaedics, University of South Florida.",
            "firstname": "Reed",
            "initials": "R",
            "lastname": "Andrews"
        },
        {
            "affiliation": "Department of Orthopaedics, University of South Florida.",
            "firstname": "Mitchel",
            "initials": "M",
            "lastname": "John"
        },
        {
            "affiliation": "Department of Orthopaedics, University of South Florida.",
            "firstname": "Khaled",
            "initials": "K",
            "lastname": "Abdelghany"
        },
        {
            "affiliation": "Department of Orthopaedics, University of South Florida.",
            "firstname": "Maykel",
            "initials": "M",
            "lastname": "Dolorit"
        },
        {
            "affiliation": "Orthopaedic Trauma Service, Florida Orthopaedic Institute.",
            "firstname": "Mir Ibrahim",
            "initials": "MI",
            "lastname": "Sajid"
        },
        {
            "affiliation": "Orthopaedic Trauma Service, Florida Orthopaedic Institute.",
            "firstname": "David",
            "initials": "D",
            "lastname": "Watson"
        },
        {
            "affiliation": "Department of Orthopaedics, University of South Florida.\nOrthopaedic Trauma Service, Florida Orthopaedic Institute.",
            "firstname": "Hassan R",
            "initials": "HR",
            "lastname": "Mir"
        }
    ],
    "conclusions": null,
    "copyrights": "Copyright \u00a9 2025 Wolters Kluwer Health, Inc. All rights reserved.",
    "doi": "10.1097/BOT.0000000000002993",
    "journal": "Journal of orthopaedic trauma",
    "keywords": [
        "Humeral Shaft Fractures",
        "Intramedullary Nailing",
        "Minimally Invasive Rotator-Interval Technique",
        "Patient-Reported Outcomes"
    ],
    "methods": null,
    "publication_date": "2025-04-11",
    "pubmed_id": "40214259",
    "results": "Seventy-one patients underwent humeral IMN (MIR-IT - 39; RTCS - 32). Fifty-five patients (MIR-IT- 30; RTCS-25) had radiographic and clinical follow up to union. Mean follow up was 7.5 months (range: 3.1-16.8 months). Patients did not vary significantly with regards to age (MIR-IT: 54.4 \u00b1 22.4; RTCS: 55.1 \u00b1 18.5 years, p=0.896), and gender (Males- MIR-IT: 46.7%, RTCS: 44%, p=0.843). There were no significant differences in nonunion (7.4% vs 4.0% p=1.0), superficial infection (3.6% vs 4% p=1.0) or iatrogenic nerve palsy (3.6% vs 4.0% p=1.0) between the MIR-IT and RTCS groups. There were no deep infections or wound dehiscences in either group. Forty-two patients had PROMs (MIR-IT -21; RTCS -21). Average time to PROMs collection was 35.7 months (MIR-IT: 34.2 months, RTCS: 37.1 months, p=0.682). There were significantly better ASES scores (82.7 vs 71.6 p=.015), Quick DASH scores (9.7 vs 21.0 p=.011) and Oxford Shoulder Scores (39.3 vs 33.9 p=.042) amongst patients treated with the MIR-IT.",
    "title": "Humeral Intramedullary Nailing Utilizing the Minimally Invasive Rotator-Interval Technique (MIR-IT) Improves Shoulder PROMs.",
    "xml": "<Element 'PubmedArticle' at 0x7885040b3d80>"
}