摘要
目的比较采用微创钢板内固定术(minimally invasive plating osteosynthesis,MIPO)和可膨胀髓内钉治疗肱骨干中段骨折的疗效。方法回顾分析2004年5月-2008年12月收治的33例肱骨干中段骨折患者临床资料,其中采用MIPO治疗14例(A组),可膨胀髓内钉治疗19例(B组)。A组:男10例,女4例;年龄21～51岁,平均35岁。车祸伤5例,摔伤6例,机器伤2例,重物压伤1例。AO分型:A型6例,B型6例,C型2例。受伤至手术时间3～11d,平均5.9d。B组:男12例,女7例;年龄19～68岁,平均40岁。车祸伤7例,摔伤8例,高处坠落伤3例,挤压伤1例。AO分型:A型10例,B型8例,C型1例。受伤至手术时间2～6d,平均4.2d。两组患者一般资料比较,差异均无统计学意义(P>0.05),具有可比性。结果 A、B组手术时间分别为(104.6±25.8)min和(85.0±35.7)min,差异无统计学意义(P>0.05)。两组术后切口均Ⅰ期愈合,无医源性桡神经麻痹发生。两组患者均获随访,A组随访时间12～37个月,平均21.4个月;B组22～35个月,平均20.5个月。X线片示两组骨折均获骨性愈合,A组骨折愈合时间为(16.4±6.1)周,B组为(15.0±2.5)周,差异无统计学意义(P>0.05)。末次随访时A、B组根据美国加州大学洛杉矶分校(UCLA)肩关节评分标准评分分别为(34.1±1.1)分和(31.8±2.6)分,Mayo肘关节评分标准评分分别为100分和(97.6±3.9)分;两组比较差异均有统计学意义(P<0.05)。结论采用MIPO治疗肱骨干中段骨折术后肩关节和肘关节功能优于可膨胀髓内钉。
Objective To compare the effectiveness of two minimally invasive methods： minimally invasive plating osteosynthesis （MIPO） and expandable intramedullary nailing technique in treatment of middle third humeral shaft fractures. Methods The clinical data were retrospectively analyzed and compared from 33 cases with middle third humeral shaft fractures between May 2004 and December 2008. All the patients were divided into 2 groups： 14 patients were treated with MIPO technique （group A） and 19 with expandable intramedullary nailing technique （group B）. In group A, there were 10 males and 4 females with an average age of 35 years （range, 21-51 years）. The disease cause was traff ic accident in 5 cases, tumbling in 6 cases, machine related trauma in 2 cases, crushed by a heavy object in 1 case. Six fractures were classified as AO type A, 6 as type B, and 2 as type C. The time from injury to operation was 3 to 11 days with an average of 5.9 days. In group B, there were 12 males and 7 females with an average age of 40 years （range, 19-68 years）. The disease cause was traffic accident in 7 cases, tumbling in 8 cases, falling from height in 3 cases, crush injury in 1 case. Ten fractures were classified as AO type A, 8 as type B, and 1 as type C. The time from injury to operation was 2 to 6 days with an average of 4.2 days. There was no signif icant difference in general data between 2 groups （P 0.05）. Results The operation time was （104.6 ± 25.8） minutes in group A and （85.0 ± 35.7） minutes in group B, showing no significant difference （P 0.05）. Incision healed by first intention without iatrogenic radial nerve palsy in 2 groups. The patients were followed up 21.4 months on average （range, 12-37 months） in group A and 20.5 months on average （range, 22-35 months） in group B. The X-ray films showed bony healing in all patients. The fracture union time was （16.4 ± 6.1） weeks in group A and （15.0 ± 2.5） weeks in group B, showing no significant difference （P 0.05）. The University of California Los Angeles （UCLA） End-Result scores were 34.1 ± 1.1 in group A and 31.8 ± 2.6 in group B and the Mayo Elbow Performance scores were 100 in group A and 97.6 ± 3.9 in group B; all showing significant differences （P 0.05）. Conclusion Good clinical outcomes could be obtained when middle third humeral shaft fractures are treated by either MIPO or expandable intramedullary nailing techniques. However, MIPO technique could offer better shoulder and elbow functional results.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2010年第12期1413-1415,共3页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
肱骨干中段骨折
微创钢板内固定术
可膨胀髓内钉
微创技术
Middle third humeral shaft fracture Minimally invasive plating osteosynthesis Expandable intramedullary nail Minimally invasive technique
