经皮闭合手法复位结合MIPO技术治疗肱骨干粉碎性骨折  

Treatment of comminuted humerus fracture by percutaneous closure manual reduction with minimally invasive plate osteosynthesis technique

作　　者：胡旭峰 丁国正 杨民 周茂生 汪正宇 

机构地区：[1]皖南医学院第一附属医院弋矶山医院创伤骨科,安徽芜湖241001

出　　处：《皖南医学院学报》2017年第5期443-445,共3页Journal of Wannan Medical College

摘　　要：目的:探讨经皮闭合手法复位结合微创钢板内固定(MIPO)技术治疗肱骨干粉碎性骨折的疗效。方法:我科自2009年10月~2015年12月采用经皮闭合手法复位结合MIPO技术治疗肱骨干粉碎性骨折共15例,其中男9例,女6例,平均年龄(57.3±5.2)岁。所有患者均为新鲜闭合性骨折,未合并有桡神经损伤,受伤至手术时间5~11 d。其中肱骨干粉碎性骨折按照AO分型(B型6例,C型9例),其中有2例肱骨干骨折患者合并有肱骨近端骨折,肱骨近端骨折按Neer分型(二部分骨折2例)。术后对肩关节功能(Constant-Murley肩关节评分标准)、肘关节功能(Mayo肘关节评分标准)、骨折愈合时间及并发症情况进行评价。结果:15例患者均获随访,随访时间为12~24月,平均(14.2±3.1)月。所有患者骨折均愈合,骨折愈合时间14~22周,平均(15.8±2.1)周,未发生钢板内固定断裂及桡神经损伤并发症,术后肩关节功能评分,优12例,良1例,可2例,肘关节功能评分,优12例,良2例,可1例。结论:应用经皮闭合手法复位结合MIPO技术治疗肱骨干粉碎性骨折,具有损伤小、不影响骨折端血供、手术时间短、骨折愈合时间短及愈合率高、肩肘关节功能恢复好等优势。Objective： To evaluate the clinical effectiveness of treatment of comminuted humerus fracture by percutaneous closure manual reduction combined with minimally invasive plate osteosynthesis（ MIPO） technique. Methods： Fifteen patients with comminuted humerus fractures,admitted to our department and treated with percutaneous closure manual reduction and MIPO technique between October 2009 and December 2015 were included. Nine patients were male and 6 were female,with an average of（ 57.3±5.2） years. All patients were fresh closed fractures without radial nerve injury. Treatment occurred between 5 and 11 days following fracture. By AO classification for comminuted humerus fractures,6 cases were associated with type B and 9 with type C,and 2 of the 15 patients were involved in fractures of humeral shaft and proximal humeral neck. By Neer＇s classification for proximal humerus fracture,and two-part fracture in 2. Postoperative evaluation was performed regarding shoulder joint function by Constant-Murley shoulder joint function scoring,elbow function by Mayo elbow scoring,fracture healing time and complications. Results： Fifteen patients were followed after operation. The follow-up ranged from 12 to 24 months with an average of（ 14.2±3.1） months. Fracture healing occurred in between 14 and 22 weeks,with an average of（ 15.8±2.1） weeks. No incidence,including broken plate following internal fixation,damage to the radial nerve and complications occurred. Constant-Murley assessment of the shoulder joint function indicated excellent in 12 cases,good in 1 and fair in 2. Elbow function assessment showed that 12 patients were in excellent recovery,2 in good recovery and 1 in fair recovery. Conclusion： Treatment of the comminuted humerus fracture by combined percutaneous closure manual reduction with MIPO technique may have many advantages,including minimal invasion,free impact on the blood supply at the fracture sites,shortened operative time,early and better fracture healing as well as sound recovery

关 键 词：闭合复位 肱骨干粉碎性骨折 微创钢板内固定技术 

分 类 号：R687.3[医药卫生—骨科学]