肱骨前路微创技术联合锁定加压接骨板内固定治疗肱骨干骨折  

Anterior humeral minimally invasive technique combined with locking compression plate fixation for treatment of humeral shaft fractures

作　　者：姚龚 蔡兵 林文 李敏 YAO Gong;CAI Bin;LIN Wen;LI Min(Department of Orthopaedics,Huangpu Branch,Shanghai Ninth People's Hospital,Shanghai Jiaotong University School of Medicine,Shanghai,200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院黄浦分院骨科,上海200011

出　　处：《当代医学》2023年第28期125-129,共5页Contemporary Medicine

摘　　要：目的探讨肱骨前路微创技术(MIPO)联合锁定加压接骨板(LCP)内固定治疗肱骨干骨折的近期疗效。方法选取2018年1月至2020年9月上海交通大学医学院附属第九人民医院收治的45例复杂肱骨干骨折患者作为研究对象,根据AO分类B型26例,C型19例。采用肱骨前侧微创入路,钢板经皮下潜行插入跨越骨折端并置于肱骨干前方,经皮锁钉螺钉固定。末次随访时,采用Constant-Murley肩关节评分系统评价肩关节功能,采用改良Mayo肘关节评分评价肘关节功能。结果本组45例患者平均手术时间(2.4±0.5)h,平均术中出血量(76.7±7.5)ml,平均住院时间(7.5±2.2)d。术后所有患者均获得随访,随访时间为6~12个月,平均(8.4±2.7)个月。末次随访给予关节功能评分,平均Constant-Murley肩关节评分(94.3±3.7)分;平均改良Mayo肘关节功能评分(93.3±3.1)分。所有患者骨折均愈合,平均愈合时间(4.1±1.2)个月。1例出现桡神经损害症状,于术后2周内神经功能恢复;1例发生了肩关节撞击症,早期取出钢板后,症状消失。结论肱骨前路微创技术联合锁定加压接骨板内固定治疗肱骨干骨折具有固定可靠,创伤小,并发症少,骨折愈合率高,关节功能恢复情况好,是治疗肱骨干骨折较理想的手术方法。Objective To investigate the short-term efficacy of anterior humeral minimally invasive technique(MIPO)combined with locking compression plate(LCP)internal fixation in the treatment of humeral shaft fractures.Methods 45 patients with complex humeral shaft fracture ad-mitted to the Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2018 to September 2020 were se-lected as the study objects.According to AO classification,26 cases were type B and 19 cases were type C.Using a minimally invasive approach to the anterior humerus,the plate was inserted subcutaneously across the fracture and placed in front of the humeral shaft.At the last follow-up,shoul-der joint function was evaluated by Constant-Murley shoulder joint score and modified Mayo Elbow joint score.Results The mean operation time,the mean intraoperative blood loss and the mean hospital stay of the 45 patients were(2.4±0.5)h,(76.7±7.5)ml and(7.5±2.2)d.All patients were fol-lowed up for 6 to 12 months,with an average of(8.4±2.7)months.The average Constant Murley shoulder joint score was 94.3±3.7 points at the last follow-up.The average Mayo elbow joint function score was improved(93.3±3.1).The fracture healed in all patients and the mean healing time was(4.1±1.2)months.One patient had symptoms of radial nerve damage,and the nerve function recovered within 2 weeks after surgery.One case devel-oped shoulder impingement,which disappeared after early removal of the plate.Conclusion The anterior humerus minimally invasive technique combined with locking compression plate internal fixation for humerus shaft fracture has reliable fixation,less trauma,fewer complications,high fracture healing rate,and good joint function recovery.It is an ideal surgical method for humerus shaft fracture.

关 键 词：肱骨干骨折 前路 微创钢板接骨术 锁定加压钢板 

分 类 号：R68[医药卫生—骨科学]