微创经皮内固定术与切开复位钢板内固定术治疗老年肱骨外科颈骨折的对比分析  

Comparative analysis of minimally invasive percutaneous plate osteosynthesis and open reduction and internal fixation in the treatment of surgical neck fracture of the elderly humerus

作　　者：祝健 ZHU Jian(Second Department of Orthopedics,Zhanshi Orthopedics Hospital,Lanxi,Zhejiang,321100,China)

机构地区：[1]浙江省兰溪市詹氏中医骨伤医院骨二科,浙江兰溪321100

出　　处：《当代医学》2022年第19期129-131,共3页Contemporary Medicine

摘　　要：目的 探究微创经皮内固定术(MIPPO)与切开复位钢板内固定术(ORIF)治疗老年肱骨外科颈骨折(HSNF)患者的效果。方法 选取2015年1月至2021年5月本院收治的112例老年HSNF患者作为研究对象进行前瞻性随机平行对照研究,按照随机数字表法分为A组与B组,各56例。A组接受MIPPO治疗,B组接受ORIF治疗。比较两组围术期指标(术中失血量、术后引流量、切口长度、住院时长),术前、术后1个月、3个月肩关节Constant-Murley评分,术前、术后12 h、术后24 h创伤应激因子[促肾上腺皮质激素(ACTH)、皮质醇(Cor)]水平。结果 A组术后引流量、术中失血量均明显少于B组,切口长度、住院时间均明显短于B组(P<0.05);术后1、3个月,A组肩关节Constant-Murley评分均明显高于B组(P<0.05);A组术后12 h、24 h血清Cor、ACTH水平明显低于B组(P<0.05)。结论 与传统ORIF治疗老年HSNF患者相比,应用MIPPO治疗更有助于优化围术期指标,改善肩关节功能,减轻手术创伤应激。Objective To investigate the effects of minimally invasive percutaneous plate osteosynthesis(MIPPO) and open reduction and internal fixation(ORIF) in the treatment of elderly patients with humerus surgical neck fractures(HSNF). Methods A total of 112 elderly HSNF patients admitted to our hospital from January 2015 to May 2021 were selected as research subjects for a prospective randomized parallel control study, and they were randomly divided into group A and group B according to the random number table method, with 56 cases in each group. Group A received MIPPO treatment and group B received ORIF treatment. Perioperative indicators(intraoperative blood loss, postoperative drainage, incision length, length of hospital stay), Constant Murley score of shoulder joint before surgery, 1 month and 3 months after surgery, and traumatic stress factor(adrenocorticotropic hormone [ACTH], cortisol [Cor]) levels before surgery, 12 h and 24 h after surgery were compared between the two groups. Results The postoperative drainage volume and intraoperative blood loss in group A were significantly less than those in group B, and the length of incision and hospital stay were significantly shorter than those in group B(P<0.05). The Constant Murley score of shoulder joint in group A was significantly higher than that in group B at 1 and 3 months after surgery(P<0.05). The levels of Cor and ACTH in group A were significantly lower than those in group B at 12 and 24 hours after surgery(P<0.05). Conclusion Compared with traditional ORIF therapy, MIPPO therapy is more helpful to optimize perioperative indicators, improve shoulder function and relieve surgical trauma stress in elderly HSNF patients.

关 键 词：切开复位 微创经皮内固定 肱骨外科颈骨折 

分 类 号：R687.3[医药卫生—骨科学]