MIPPO和切开复位固定术对肱骨外科颈骨折的疗效及骨折愈合时间差异的研究  

Study on the Effect of MIPPO and Open Reduction and Fixation on Humeral Surgical Neck Fracture and the Difference of Fracture Healing Time

作　　者：欧锐金 谭文乐 黄东博 谭建基 OU Rui-jin;TAN Wen-le;HUANG Dong-bo(Deopartment of surgery,the Peoples hospital of Luoding city,Guangdong province 527200)

机构地区：[1]罗定市人民医院外二科,广东罗定527200

出　　处：《中国伤残医学》2022年第9期26-29,共4页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:探讨经皮微创钢板内固定术(MIPPO)和切开复位固定术对肱骨外科颈骨折的疗效及骨折愈合时间差异。方法:选择我院于2014年4月-2019年4月接诊的肱骨外科颈骨折病人80例,按随机数字表法分为2组。观察组40例均实施MIPPO,对照组40例均实施切开复位固定术。记录并对比2组病人的围术期指标、术后肩关节恢复情况以及并发症发生率。其中围术期指标包括术中出血量、手术切口长度、手术时间及住院时间;术后肩关节恢复情况包括骨折愈合时间、出院时VAS疼痛评分情况以及Neer肩关节功能评分。结果:观察组病人术中出血量、手术切口长度、手术时间及住院时间均较对照组低,差异具有统计学意义(P<0.05)。观察组病人骨折愈合时间、出院时VAS疼痛评分均低于对照组,而Neer肩关节功能评分高于对照组,差异具有统计学意义(P<0.05)。2组病人均未出现深部感染,肱骨头坏死、钢板断裂,仅对照组出现1例骨折延迟愈合、1例关节活动受限,2组数据比较,差异不具有统计学意义(P>0.05)。结论:和切开复位固定术相比,MIPPO在治疗肱骨外科颈骨折方面能够改善病人周术期指标,加德其术后肩关节恢复,值得临床推广使用。Objective:To investigate the effect of minimally invasive percutaneous plate osteosynthesis(MIPPO)and open reduction and fixation in the treatment of humeral surgical neck fracture and the difference of fracture healing time.Methods:80 patients with humeral surgical neck fracture treated in our hospital from April 2014 to April 2019 were selected and randomly divided into two groups.The study group was treated with MIPPO,and the control group was treated with open reduction and fixation.The perioperative indexes,postoperative shoulder joint recovery and complication rate of the two groups were recorded and compared.The perioperative indicators included intraoperative blood loss,incision length,operation time and hospital stay;postoperative shoulder joint recovery included fracture healing time,VAS pain score at discharge and Neer shoulder function score.Results:The intraoperative blood loss,incision length,operation time and hospital stay in the study group were lower than those in the control group(P<0.05).The fracture healing time and VAS pain score at discharge of the study group were lower than those of the control group,while Neer shoulder function score was higher than that of the control group,the difference was statistically significant(P<0.05).There was no deep infection,humeral head necrosis and plate fracture in the two groups.Only 1 case of delayed union of fracture and 1 case of limited joint activity occurred in the control group.The differ ence between the two groups was not statistically significant(P>0.05).Conclusion:Compared with open reduction and fixation,MIPPO in the treatment of humeral surgical neck fracture can improve the perioperative indicators of patients and accelerate the recovery of shoulder joint after operation,which is worthy of clinical application.

关 键 词：经皮微创钢板内固定术 切开复位固定术 肱骨外科颈骨折 疗效 骨折愈合时间 

分 类 号：R683.41[医药卫生—骨科学]