MIPPO技术结合LCP治疗老年骨质疏松肱骨近端骨折的临床疗效  

The Clinical Effect of MIPPO Combined with LCP in the Treatment of Elderly Patients with Osteoporotic Proximal Humerus Fractures

作　　者：熊林 夏炳树 王军 陈超坤 张志平 

机构地区：[1]广东省中山市板芙医院,广东中山528459

出　　处：《中国医学创新》2017年第1期37-40,共4页Medical Innovation of China

摘　　要：目的:比较微创经皮钢板内固定(MIPPO)结合锁定加压钢板(LCP)手术与常规解剖钢板内固定(ORIF)治疗老年骨质疏松肱骨近端骨折的临床疗效。方法:2011年8月-2015年12月因新鲜老年骨质疏松肱骨近端骨折行手术治疗并获得随访的患者46例,按照随机数字表法分为MIPPO组(MIPPO结合LCP)26例,ORIF组(常规解剖钢板内固定)20例。对比分析两组患者一般资料、手术时间、术中透视次数、术中出血量、平均住院天数、骨折愈合时间、术后发生钢板螺钉松动、断裂以及骨折不愈合等并发症发生率,Neer’s评分评价肩关节功能。结果:MIPPO组患者手术切口长度、手术时间、出血量、术后住院时间和骨折愈合时间显著优于ORIF组,比较差异均有统计学意义(P<0.05)。术后肩关节功能Neer评分,MIPPO组优良率92.3%,ORIF组优良率80.0%,MIPPO组优于ORIF组,两组比较差异均有统计学意义(P<0.05)。随访结束后显示ORIF组患者伤口浅表感染3例、骨折延迟愈合2例,两组均无骨折不愈合、继发性神经损伤、血管损伤、内固定断裂失败、肩峰撞击中等并发症。结论:MIPPO结合LCP手术治疗老年骨质疏松肱骨近端骨折手术简单易行,术后临床疗效好且肩关节功能恢复良好,因而值得推广。Objective：To investigate and compare the clinical effectof minimally invasive percutaneous plate osteosynthesis（MIPPO） combined with locking compression plate（LCP） with normal anatomic plate internal fixation（ORIF） in the treatment of osteoporotic proximal humerus fractures.Method：From August 2011 to December 2015,46 patients with fresh osteoporotic proximal humerus fracture received surgical treatment were divided into two groups according to the random number table methods,MIPPO group（26 cases） who were treated with MIPPO combined with LCP,and ORIF group（20 cases） who were fixed through ORIF.Medical record was collected to compare demographic data,operation time,intraoperative fluoroscopy frequency, blood loss,duration of hospitalization,time to union,rate of complications,and Neer shoulder joint functional score.Result：The incision length, operative time, blood loss, postoperative hospital stay and fracture healing time of MIPPO group were significantly better than those of ORIF group,the differences were statistically significant（ P〈0.05）.Neer score of shoulder joint function after operation, the excellent and good rate of MIPPO group was 92.3% higher than that of ORIF group 80.0%,the difference between the two groups was statistically significant（P〈0.05）. By the end of follow-up showed that ORIF group patients with superficial wound infection in 3 cases, delayed fracture healing in 2 cases, the two groups had no nonunion, secondary nerve injury, vascular injury, fracture fixation failure, impingement secondary complications.Conclusion：MIPPO combined with LCP is a very effective way in the treatment of osteoporotic proximal humerus fractures,with good operability and better clinical efect,which is worthy of clinical application.

关 键 词：肱骨近端骨折 微创经皮接骨板技术 锁定加压钢板 老年患者 临床疗效 

分 类 号：R687.3[医药卫生—骨科学] R580[医药卫生—外科学]