微创钢板内固定结合肱骨近端锁定钢板在肱骨骨折治疗中的应用

目的探讨运用经皮微创钢板内固定技术（MIPPO）结合肱骨近端锁定钢板（LPHP）治疗肱骨近端骨折的临床疗效。方法回顾性分析本组2010年2月至2014年3月采用MIPPO技术结合LPHP治疗肱骨近端骨折患者28例,传统切开复位内固定（ORIF）患者25例。比较两组术中切口长度、出血情况、手术时间、术后骨折愈合时间、肩关节功能恢复,并进行统计学分析。结果 53例均获得随访,随访时间6-20个月,平均14.3个月,MIPPO组在手术切口、手术时间、出血量优于ORIF组,差异具有统计学意义（P〈0.05）;而在骨折愈合时间及肩关节功能恢复方面两组无统计学差异（P〉0.05）。结论应用MIPPO技术结合LPHP内固定较ORIF结合LPHP治疗肱骨近端骨折具有创伤小,固定可靠的优势,是治疗肱骨近端骨折更为合适的手段。

Application of minimally invasive percutaneous plate osteosynthesis combined with locking proximal humerus plate for treatment of proximal humeral fractures

Objective To discuss the clinical efficacy of minimally invasive percutaneous plate osteosynthesis（MIPPO） combined locking proximal humerus plate（LPHP） for the treatment of proximal humeral fractures.Methods Fifty-three cases admitted in our hospital from Feb.2010 to Mar.2014 were reviewed.Among these cases,28 cases were treated with MIPPO combining LPHP as the MIPPO group,and 25 cases were treated with open reduction and internal fixation（ORIF） combining LPHP as the ORIF group.The incision length,operation time,blood loss,fracture healing time and the functional recovery were compared between the two groups and statistical analysis was performed.Results Fifty-three patients were followed up for 6 to 20 months（mean 14.3 months）.There was statistical difference in regard of the incision length,the operation time and the blood loss in the two groups（P〈0.05）.Shorter fracture healing time and higher functional recovery rate were observed in the MIPPO group,but with no statistically significant difference（P〉0.05）.Conclusion Comparing with ORIF combining LPHP,less operative damage and better internal fixation could be achieved by MIPPO combining LPHP.MIPPO is more appropriate for treating the proximal humeral fractures.