微创经皮钢板接骨术治疗肱骨近端骨折

目的探讨微创经皮钢板接骨术(minimally invasive percutaneous plate osteosynthesis,MIPPO)在肱骨近端骨折的临床应用及疗效。方法回顾性分析我科从2010年5月至2012年2月运用MIPPO技术结合锁定钢板治疗的19例肱骨近端骨折患者,根据NEER分类,属二部分骨折5例,属三部分骨折11例,属四部分骨折3例。围手术期预防性使用抗生素,术后肩关节功能采用Neer评分标准评估。结果本组患者均获随访,随访时间6~12个月,平均8个月。随访的患者均无骨折不愈合、延迟愈合、伤口感染及内固定失败等并发症。术后肩关节功能恢复依据Neer评分标准,优10例,良7例,可2例,总优良率为89.4%。结论采用MIPPO技术治疗肱骨近端骨折具有创伤小、术中术后出血少、伤口美观、固定牢固、骨折愈合率高以及能够早期功能锻炼的优点,值得在治疗肱骨近端骨折中应用推广,但对于粉碎性骨折尚有局限性。

Clinical Research of the Minimally Invasive Percutaneous Plate Osteosynthesis for Proximal Humeral Fractures

Abstract：Objective To discuss the clinical application of the minimally invasive percutaneousplate osteosynthesis on proximal humeral fractures and evaluate its clinical effects. Methods There were 19 proximal humeral fractures treated with the latest minimally invasive percutaneousplate osteosynthesis from 2011 to 2012. According to Neer classification,5 cases had two-part fractures, 11 had three part fractures, and 3 had four-part fractures. Prophylactic use of antibiotics during was adopted perioperative period. The shoulder function after treatment was evaluated according by Neer scoring system. Results All the 19 cases were followed up for 6 to 12 months, with an average of 8 months. The functional results of the shoulder, according to Neer scores,were classified as excellent in 10 cases,good in 7 cases and fair in 2 cases,with an average score was 89.4%. Conclusion Minimally invasive percutaneousplate osteosynthesis has the advantage of less trauma, small incision less bleed- ing and infeetion good fixation and high union rate. It is worth to be popularized in the treatment of proximal humeral fractures.