微创内固定与切开复位钢板内固定治疗肱骨投弹骨折疗效比较  

Minimally invasive internal fixation versus plating by open reduction and internal fixation in treatment of throwing fracture of the humeral shaft

作　　者：宋子卫[1] 林舟丹[1] 刘传太[1] 程昌志[1] 李贵谦[1] 

机构地区：[1]解放军第303医院骨科,广西南宁530021

出　　处：《临床骨科杂志》2011年第1期67-69,共3页Journal of Clinical Orthopaedics

摘　　要：目的比较微创内固定(MIIF)与切开复位钢板内固定(ORIF)治疗肱骨投弹骨折的疗效。方法肱骨投弹骨折55例患者中28例采取MIIF治疗,27例采取ORIF治疗。术中记录手术时间、出血量、术后住院时间;随访记录骨折平均愈合时间、并发症及肩、肘关节功能恢复情况。对两组疗效进行比较。结果所有患者均获随访,时间8～25(19.5±3.1)个月。与ORIF组比较,MIIF组在手术时间、出血量、骨折平均愈合时间及周围神经损伤、感染、筋膜间隙综合征、再骨折等并发症的发生率等方面差异有统计学意义(P<0.05)。肩、肘关节功能评分按Rodriguez-Merchan评价标准:MIIF组优良率(27/28,96%)高于ORIF组(21/27,78%)差异有统计学意义(P<0.05)。结论采用MIIF治疗肱骨投弹骨折,操作简单,手术安全,损伤小,固定合理,骨折愈合时间短,功能恢复满意。Objective To comparatively analyze the clinical effects of minimally invasive internal fixation （MIIF）and open reduction and internal fixation （ORIF） in treatment of throwing fracture of the humeral shaft. Methods In 55 cases with throwing fracture of the humeral shaft, 28 cases were treated with screws by MIIF, and 27 cases with plate by ORIF. The results were compared. Operation time, bleeding volmne, length of stay and average time of fracture u- nion, incidence rate of complications and shoulder and elbow function were recorded. Results All cases were followed up for 8 - 25 （ 19.5 ＋ 3.1 ） months. There were significant differences in operation time, bleeding volume and average time of fracture union between Group MIIF and Group ORIF respectively（P 〈 O. 05 ）. There were significant differences in incidence rate of complications, such as peripheral nerve injury, infection and compartment syndrome between Group MIIF and Group ORIF respectively （P 〈 O. 05 ）. Shoulder and elbow score （Rodriguez-Merchan criteria） in Group MIIF（27/28,96% ） was significantly higher than that in Group ORIF（21/27,78% ） （P 〈0. 05）. Conclusions Minimally invasive internal fixation has advantages of simplicity, safety, less injury, short fracture union time and better shoulder and elbow function in treatment of throwing fracture of the humeral shaft.

关 键 词：肱骨骨折 投弹骨折 外科手术 微创性 骨折固定术 内 

分 类 号：R683.41[医药卫生—骨科学] R687.32[医药卫生—外科学]