锁定钢板与髓内钉2种微创方法内固定治疗肱骨干复杂骨折的疗效比较  

Comparative study of two kinds of minimally invasive therapeutic methods for complex humeral fracture: minimally invasive plate and minimal invasive nail osteosynthesis

作　　者：罗旭耀[1] 严力生[1] 钱海平[1] 钮心刚[1] 宫峰[1] 梁志民[1] 陈红梅[1] 

机构地区：[1]解放军第411医院骨科,上海200081

出　　处：《中国骨与关节损伤杂志》2015年第7期713-715,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的 回顾性研究比较锁定加压钢板与交锁髓内钉2种微创方法内固定治疗肱骨干复杂骨折的临床疗效。方法自2001-01—2014-06采用交锁髓内钉经皮穿钉闭合复位（MINO）治疗肱骨干复杂骨折（AO分型B型及C型）25例,自2007-01—2014-06采用锁定加压钢板经皮微创固定（MIPO）治疗同型骨折21例。结果 MINO组术后3例,MIPO组术后1例出现桡神经一过性损伤,随访3周~4个月后均完全恢复,2组差异无统计学意义（P〉0.05）。骨折愈合时间：MINO组（25.08±10.70）周,MIPO组（22.76±5.77）周,差异无统计学意义（P〉0.05）。肩关节UCLA评分：MINO组（31.44±2.18）分,MIPO组（33.05±1.32）分,差异有统计学意义（P〈0.01）。肘关节Mayo评分：MINO组（98.96±1.27）分,MIPO组（98.81±1.57）分,差异无统计学意义（P〉0.05）。结论 采用MIPO和MINO 2种微创方法内固定治疗肱骨干复杂骨折均可获得良好愈合,MIPO技术内固定术后肩关节功能相对较好。Objective To compare the therapeutic efficiency between minimally invasive nail osteosynthesis （MINO） and minimally invasive plate osteosynthesis （MIPO） in the treatment of complex humeral shaft fractures. Methods The clinical data were retrospectively analyzed and compared from 46 cases of complex humeral shaft fractures in our hospital between January 2001 and June 2014. Data were divided into two groups according to the methods of treatment. In group A 25 patients were treated with MINO, while in group B 21 patients were treated with MIPO. The fracture healing time, and shoulder and elbow values were recorded and analyzed. The functions of the affected ahoulder and elbow were assessed with the University of California Los Angeles （UCLA） and Mayo elbow performance score system respectively. Results Radial nerve palsy occurred in 3 cases of group A and 1 case in group B, showing no significant difference （P 〉0.05）, and all cases recovered 3 weeks to 4 months later. The X-ray films showed bony healing in all patients. The fracture union time were （25.08±10.70） weeks in group A and （22.76±5.77） weeks in group B, showed no significant difference （P 〉0.05）. The UCLA scores were （31.44±2.18） in group A and （33.05±1.32） in group B, showed significant differences（P 〈0.01）. The Mayo elbow performance scores were （98.96±1.27） in group A and （98.81±1.57） in group B, showed no sign/ficant difference （P 〉0.05）. Conclusion Bony healing and good result can be obtained when complex humeral shaft fractures are treated with either MINO or MIPO. However, MIPO technique can offer better shoulder function.

关 键 词：肱骨干骨折 微创钢板内固定术 微创髓内钉内固定术 

分 类 号：R683.41[医药卫生—骨科学]