前侧入路微创钢板内固定技术治疗肱骨干r中下段粉碎性骨折的临床分析

摘要

Objective To discuss the clinical approaches and effects of minimally invasive percutaneous plate ostosynthesis( MIPPO) technique via anterior approach in the treatment of middle-distal humeral shaft frac-tures.Methods A retrospective analysis was performed on 20 patients(16 males and 4 females, aged from 33-62 years with an average of 47.3 years) undergoing MIPPO technique from Apr.2008 to Aug.2009 for the treatment of closed middle-distal humeral shaft fractures.The curative rate and mean healing time were observed.The functions of the affected shoulder and elbow were assessed with the UCLA and the Mayo elbow performance score system re-spectively.Results All the wounds healed primarily and there was no iatrogenic radial nerve palsies after surgery. The average bone healing time was 18 weeks.According to the UCLA shoulder score system,all the wounds were ex-cellent.The Mayo elbow performance score system showed that the scores were excellent in 18 patients,and good in 2 patients.Conclusion The MIPPO technique via anterior approach applied for the treatment of middle-distal hu-meral shaft fractures is more advisable for its greater safety and feasibility.Strict screening of the indications and the precision of surgical precedures are the prerequisites for the successful treatment with the MIPPO technique.%目的 探讨经皮前侧入路微创钢板内固定(MIPPO)技术治疗肱骨干中下段骨折的临床方法和疗效.方法 回顾性分析2008年4月~2013年10月采用经皮前侧入路MIPPO技术治疗20例肱骨干中下段闭合性粉碎性骨折临床资料,男性16例,女性4例;平均年龄47.3岁(33~62岁),观察治愈率、平均愈合时间等,采用美国加州大学肩关节评分(UCLA)标准和Mayo肘关节功能评分标准评价肩肘关节功能.结果 所有患者切口均Ⅰ期愈合,桡神经功能术后无恶化,骨折愈合时间平均为18周,Mayo肘关节功能评分显示:优18例,良2例.结论 在肱骨干中下段经前侧入路的MIPPO技术安全、易操作,严格的病例筛选是MIPPO技术治疗成功的前提.