外侧入路MIPPO技术治疗肱骨干粉碎性骨折的疗效观察  

The Clinical Observation on Application of MIPPO Technique in the Treatment of Humeral Shaft Comminuted Fracture with Lateral Approach

作　　者：宋正鑫[1] 杨东翔[1] 刘岩[1] 卫力晋[1] 

机构地区：[1]北京京煤集团总医院骨科,北京102300

出　　处：《实用骨科杂志》2016年第5期390-392,共3页Journal of Practical Orthopaedics

摘　　要：目的探讨经外侧入路应用经皮微创钢板接骨术（minimally invasive percutaneous plate osteosynthesis,MIPPO）治疗肱骨干粉碎性骨折的临床疗效。方法对我院2011年3月至2014年12月收治的26例肱骨干粉碎性骨折患者进行前瞻性分析。其中14例采用MIPPO技术手术治疗,男8例,女6例;年龄22~63岁,平均43.5岁;左侧5例,右侧9例。12例采用切开复位手术治疗,男7例,女5例;年龄27~59岁,平均41.5岁;左侧5例,右侧7例。两组均采用外侧锁定钛板进行固定。比较两组手术操作时间、术中出血量、术后并发症等情况;术后进行体格检查、X线片检查,并参照Constant-Murley肩关节评分及Mayo肘关节评分标准进行功能评估。结果所有患者均顺利完成手术。常规组术后出现1例切口脂肪液化,2例桡神经一过性损伤;MIPPO组术后均无并发症发生。所有患者均获随访,MIPPO组随访时间12~24个月（平均16.3个月）,常规组11~30个月（平均17.2个月）。两组术中出血量、骨折愈合时间、末次随访时肩关节Constant-Murley评分及肘关节Mayo评分,差异均有统计学意义（P〈0.05）,两组术中操作时间比较差异无统计学意义（P〉0.05）。结论经外侧入路应用MIPPO技术治疗肱骨干粉碎性骨折的临床疗效优于常规切开复位手术。Objective To explore the clinical effect of MIPPO technique in the treatment of humeral shaft comminuted fracture with the lateral approach. Methods In this study,26 patients of humeral shaft comminuted fracture from March 2011 to December 2014 treated in our hospital was analyzed prospectively. Among them,14 cases were treated with MIPPO technique. There were 8 males and 6 females,aged from 22 to 63 years old,with the mean age of 43. 5 years,5 cases of left and right 9 cases. According to AO classification,there were 3 cases of type A,9 cases of type B and 2 cases of type C. 12 cases were treated by open reduction surgery. There were 7 males and 5 females,aged from 27 to 59 years,with the mean age of 41.5 years; 5 cases of left and right 7 cases. According to AO classification,there were 3 cases of type A,7 cases of type B and 2cases of type C. The two groups were fixed with lateral locking titanium plate. The operation time,intraoperative blood loss and postoperative complications were compared between the two groups; the patients were followed up with postoperative physical examinations and X ray examinations,and with reference to Constant-Murley shoulder score and Mayo elbow score standard for functional evaluation. Results The operations were performed successfully in all patients. In the conventional group,there were 1 cases of incision fat liquefaction,2 cases of radial nerve injury after operation,and no complication occurred in group MIPPO after operation. All patients were followed up,MIPPO group were followed up 12 ~ 24 months（ mean 16. 3 months）,conventional group 11 ~ 30 months（ mean 17. 2 months）. There were statistical differences in blood loss,fracture healing time,shoulder Constant-Murley score and Mayo elbow score at last follow-up in two groups（ P〈0. 05）,and no statistical differences in the operation time（ P〈0. 05）. Conclusion The clinical curative effect of application of MIPPO technique in the treatment of humeral shaft comminuted fracture with lateral approach is superio

关 键 词：外侧入路 经皮微创钢板接骨术 肱骨干骨折 粉碎性 

分 类 号：R683.41[医药卫生—骨科学]