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The sample involved ten upper extremities. Application of a PHILOS plate was performed through a Delta-split. Intervals between the AN, MN, RN and the medial vascular bundle were defined at various positions. The humeral shaft was artificially fractured at a height of about the mean of the plate. The distal fragment was brought into 15\u00b0 and 30\u00b0 internal (IR) as well as external rotation (ER) and here, the plate\u2019s relation to the RN was evaluated. The medial neurovascular bundle intersected the plate at its distal part in two specimens. Regarding the distances from the RN to the plate during different rotation positions the distances became significantly longer during ER, respectively shorter during IR. The medial neurovascular bundle and the RN were identified as the main structures at risk. Care must be taken during distal screw placement and malrotation exceeding 15\u00b0 must be avoided during MIPO.<\/jats:p>","DOI":"10.1038\/s41598-021-04041-w","type":"journal-article","created":{"date-parts":[[2022,1,7]],"date-time":"2022-01-07T11:03:21Z","timestamp":1641553401000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Minimally invasive plate osteosynthesis of the humeral shaft with regard to adjacent anatomical characteristics"],"prefix":"10.1038","volume":"12","author":[{"given":"Gloria Maria","family":"Hohenberger","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georg","family":"Lipnik","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angelika Maria","family":"Schwarz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Grechenig","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magdalena","family":"Holter","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas Heinrich","family":"Weiglein","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,1,7]]},"reference":[{"key":"4041_CR1","doi-asserted-by":"publisher","first-page":"1469","DOI":"10.1302\/0301-620X.88B11.17634","volume":"88","author":"R Ekholm","year":"2006","unstructured":"Ekholm, R. et al. Fractures of the shaft of the humerus. An epidemiological study of 401 fractures. J. Bone Joint Surg Br. 88, 1469\u20131473 (2006).","journal-title":"J. Bone Joint Surg Br."},{"key":"4041_CR2","doi-asserted-by":"publisher","first-page":"406","DOI":"10.3944\/AOTT.2014.13.0009","volume":"48","author":"G Huri","year":"2014","unstructured":"Huri, G., Bi\u00e7er, \u00d6. S., \u00d6zt\u00fcrk, H., Deveci, M. A. & Tan, I. Functional outcomes of minimal invasive percutaneous plate osteosynthesis (MIPPO) in humerus shaft fractures: A clinical study. Acta Orthop. Traumatol. Turc. 48, 406\u2013412 (2014).","journal-title":"Acta Orthop. Traumatol. Turc."},{"key":"4041_CR3","doi-asserted-by":"publisher","first-page":"1741","DOI":"10.1016\/j.jse.2015.07.032","volume":"24","author":"C Wang","year":"2015","unstructured":"Wang, C., Li, J., Li, Y., Dai, G. & Wang, M. Is minimally invasive plating osteosynthesis for humeral shaft fracture advantageous compared with the conventional open technique?. J. 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All ICMJE Conflict of Interest Forms for authors are on file and can be viewed on request.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"279"}}