经皮微创接骨板固定术外侧切口在老年肱骨近端骨折中的应用

目的 探讨在肱骨近端骨折(PFHs)中应用上臂近端经皮微创接骨板固定术(MIPPO)外侧切口的临床疗效.方法 2019年1月至2020年9月福建中医药大学附属第二人民医院骨伤科PHFs患者共51例;男15例,女36例;平均年龄73.3(68～85)岁.均为Neer分型的Ⅱ型骨折及不伴有粉碎及脱位的Ⅲ型骨折,术前无肩袖损...

Clinical application of lateral Mippo incision in senile proximal humerus fracture

Objective To investigate the clinical application of Mippo incision on proximal lateral upper arm in proximal humerus fracture(PFHs).Methods From January 2019 to September 2020,a total of 51 PHFs cases of Department of Orthopaedic Surgery,the Second People's Hospital Affiliated to Fujian University of Chinese Medicine were collected;15 cases were male,36 patients were female;the average age of the patients was 73.3(68-85)years.Inclusion criteria was Neer partingⅡpart fracture,without crushingⅢpart of the fracture and dislocation.Exclusion criteria was crushⅢpart of the fracture and dislocation,fractureⅣpart,preoperative associated with rotator cuff injury.During the operation,longitudinal incision was made to the distal end 2 cm and 7 cm from the subacromial,and the broken end of the fracture was reduced along the deltoid space.After intraoperative X-ray satisfactory,plate and screw fixation was performed.X-ray reexamination was made half a year after surgery,and Neer shoulder function score was obtained.Results All cases are completed by lateral MIPPO incision surgery.Postoperative complications such as under the axillary nerve,shoulder peak hit complications did not appear.After half year,front and side X-ray films of shoulder joint shown that the fractures were all clinically recovered with humerus neck stem angle in 130-140°and caster angle in 20-35°.Shoulder activities of joint of 50 cases were good.The Neer shoulder joint function score was 90.5(85-92).One case of postoperative concurrent with the lateral humerus head necrosis,shoulder joint activity limited with 70 Neer shoulder joint function score.Conclusion For Neer partingⅡpart of the fracture without crushingⅢpart of the fracture and dislocation,lateral MIPPO incision can obtain good clinical effect,but need to strictly control the indications.