经皮锁定钢板治疗老年肱骨干骨折

目的探讨MIPPO技术治疗老年骨质疏松性肱骨干骨折的可行性和临床效果。方法采用外侧小切口置入锁定钢板桥接固定治疗21例老年骨质疏松性肱骨干骨折患者。结果手术时间52~80 min;术中出血量120~250 ml,术后无输血。患者伤口全部一期愈合。21例均获随访,时间9~15个月,骨折均愈合,X线片复查骨折对位对线良好。近期随访肩关节ROM:前屈130°~150°、后伸20°~35°、外展140°~165°、内收50°~65°;根据HSS肩关节功能评分评定,优8例,良9例,中3例,差1例。肘关节ROM:伸展5°~15°、屈曲125°~140°;根据Mayo肘关节评分评估,结果为优7例,良12例,中1例,差1例。结论外侧入路置入锁定钢板MIPPO技术创伤小、并发症少、骨愈合率高,是治疗老年肱骨干骨折的有效方法。

Minimally invasive percutaneous locking plate osteosynthesis for treatment of osteoporotic hu-meral fractures in the elderly

Objective To investigate the feasibility and effect of minimally invasive percutaneous plate osteosynthesis （ MIPPO） for old patients with proximal humerus osteoporotic fracture. Methods 21 old patients with proximal hu-merus osteoporotic fracture were treaed by minimally invasive locking plate internal fixation. Results Operation time was 52-80 min;Intraoperative hemorrhage was 120-250 ml. No blood transfusion was required, and all got prima-ry wound healing. The follow-up time was 9-15 months, all patients got union of fracture through X-ray. The func-tion of shoulder joint was forward bending 130°-150°, dorsal flexion 20°-35°, abduction 140°-165°, adduction 50°-65°;According to the HSS shoulder joint fuction scores,the results was excellent in 8 cases, good in 9, fair in 3, and poor in 1. The function of elbow joint were forward bending 125°-140°, dorsal flexion 5°-15°;According to the evaluation of Mayo elbow score,the function of elbow was excellent in 7 cases, good in 12, fair in 1, and poor in 1. Conclusions Minimally invasive locking plate internal fixation for the proximal humerus fractures of old pa-tients is less invasive and less complication with better effect and fracture healing.