微创小切口经皮锁定钢板治疗肱骨近端骨折的临床研究

摘要

目的 观察微创小切口经皮锁定钢板治疗肱骨近端骨折的临床效果.方法 回顾性分析我院2006年4月～2010年5月收治的肱骨近端骨折40例临床资料.随机将40例患者分为两组,MIPPO组20例采用微创小切口经皮锁定钢板内固定,常规组采用切开复位内固定.按照Neer功能评定标准进行评分.结果 全部患者均获随访8～36个月,平均15.6个月.MIPPO组较常规组平均出血量减少138 ml,P<0.05.手术时间MIPPO组平均较常规组缩短22 min,P<0.05.两组骨折愈合时间比较差异无统计学意义.平均住院日两组比较差异无统计学意义.MIPPO组与常规组术后并发症无明显差异,但MIPPO组患者术后肩关节功能恢复情况明显比常规组好,P<0.01.结论 锁定加压钢板具有钉-板角度稳定性强和对骨膜血供损伤小的生物学固定优点,同时运用小切口经皮微创技术内固定治疗肱骨近端骨折符合生物学固定原则,具有术中出血量少、手术时间短、手术切口小、肩关节功能恢复好等优点.%Objective To investigate the clinical effect of minimally invasive percutaneous locking plate in the treatment of proximal humeral fractures. Methods The clinical data of 40 patients with proximal humeral fractures in our hospital from April 2006 to May 2010 was retrospectively analyzed. The 40 patients were randomly divided into 2 groups: MIPPO group (20 patients, treated with minimally invasive percutaneous locking plate fixation) and the control group (20 patients, treated with open reduction and internal fixation). Functional assessment was performed according to the standard rate neet. Results All patients were followed up 8 to 36 months, with an average of 15.6 months. Compared with the control group, the average blood loss in the MIPPO group was 138 ml lower (P ＜0.05),and the average operation time in the MIPPO group was 22 min shorter (P ＜0.05). The two groups showed no statistically significant difference in the healing time, the average length of stay, and postoperatiye complications. But recovery of shoulder function in the MIPPO group was significantly better than that in the control group (P ＜0.01). Conclusion The locking compression plate has the advantages of strong nail-plate angle stability and less damage to the periosteal blood supply. Using small incision minimally invasive percutaneous fixation in the treatment of proximal humeral fractures is consistent with the principles of biological fixation, with less blood loss, shorter operative time,smaller surgical incision, and better functional recovery of the shoulder joint.