上臂前侧入路微创钢板接骨术治疗肱骨干骨折  

Treatment of humerus shaft fractures using minimally invasive peractaneous plate osteosynthesis through anterior approach

作　　者：王正红[1] 向明[1] 谢杰[1] 唐浩琛[1] 陈杭[1] 刘昕[1] 

机构地区：[1]四川省骨科医院四病区,四川成都610041

出　　处：《中国骨伤》2009年第9期681-683,共3页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨上臂前侧入路微创钢板接骨术(MIPO)治疗肱骨干骨折的方法及疗效。方法:2006年1月至2007年10月,采用上臂前侧入路行微创钢板接骨术治疗肱骨干骨折15例,其中男11例,女4例;年龄16～59岁,平均35岁;病程5～10d,平均7.5d。骨折按AO分型:A型6例,B型8例,C型1例。手术均选用AO4.5mm限制接触窄动力加压接骨板固定。对本组患者手术前后进行查体,观察肩、肘关节运动,检查其功能情况,将数据进行比较。结果:随访5～18个月,平均10个月。根据Gill临床上肢评分评定,优12例,良3例。Gill评分由术前的平均(59.33±8.21)分升至术后的平均(84.67±5.81)分。术后2～3个月骨折均临床愈合,患者恢复日常生活。无神经损伤、切口感染、内固定失败、骨折不愈合等并发症。结论:上臂前侧入路微创钢板接骨术治疗肱骨干骨折是可行的,能有效避免损伤桡神经,有利于骨折早期愈合。Objective：To discuss the method and effects of treatment of minimally invasive percutaneous plate ostosynthesis （MIPO） through anterior approach for the treatment of humerus shaft fractures. Methods ：2006.1 to 2007.10,15 patients with hmuerus shaft fractures were treated with MIPO through anterior approach. There were 11 males and 4 females,ranging in age from 16 to 59 years,with an average of 35 years old. The duration of the disease was 7.5 days on average （5 to 10 days ）. Six patients had Type A fractures, 8 Type B,and 1 Type C according to AO classification. The AO LC-DCP with diameter of 4.5 mm was chosen in the operation. The patients were physically examined preoperatively and postoperatively,the range of motion of shoulder and elbow joint was observed, and the joint function was included. Results ： All the patients were followed up for a period ranging from 5 to 18 months ,averaged 10 months. In terms of Gill ipsilateral total shoulder and elbow arthroplasties, 12 patients got an excellent result （≥ 80 scores）, 3 good （between the scores of 66 and 79）. The Gill score increased from preoperative （59.33±8.21） to postoperative （84.67±5.81）. Fractures were healed after 2 to 3 months after operation, and patients resumed daily life without the complications of nervous lesion, incision infection, internal fixation failure and nonunion of fracture etc. Conclusion：h is feasible for the treatment of humerus shaft fracture using MIPO through anterior approach,to avoid radial nerve injury and to prompt fracture union.

关 键 词：肱骨骨折 骨折固定术 内 外科手术 治疗结果 

分 类 号：R683.42[医药卫生—骨科学] R683.41[医药卫生—外科学]