Comparison of minimally invasive percutaneous plate osteosynthesis and open reduction plate internal fixation in the treatment of humeral shaft fracture
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摘要: 目的 探讨微创经皮钢板接骨术(minimally invasive percutaneous plate osteosynthesis,MIPPO)治疗肱骨干骨折的疗效。 方法 选择蚌埠医学院第一附属医院骨科2015年2月—2019年12月收治的16例肱骨干骨折患者,根据随机数字表法分为观察组和对照组,观察组实施MIPPO技术,对照组行切开复位钢板内固定。比较2组患者的手术时间、出血量、切口长度、住院时间、术后并发症、骨折愈合情况及末次随访时的上肢功能情况。 结果 观察组与对照组手术时间[(96.25±10.61) min vs.(113.75±13.03) min]、切口长度[(9.38±0.74) cm vs.(13.25±2.05) cm]、出血量[(93.75±29.25) mL vs.(293.75±120.82) mL]比较,观察组明显短于对照组(均P<0.05),2组住院时间[(11.63±4.96) d vs.(13.75±5.55) d]比较,虽然观察组短于对照组,但差异无统计学意义(P>0.05);观察组所有患者切口顺利愈合、无感染、桡神经损伤等并发症发生,对照组切口脂肪液化1例,术后桡神经损伤症状1例,均经对症处理后好转;2组患者骨折均顺利愈合,且观察组平均愈合时间[(16.00±1.07)周]低于对照组[(18.38±1.51)周],差异有统计学意义(P<0.05);末次随访时观察组DASH测量值[(13.35±1.52)分]优于对照组[(18.33±4.76)分],差异有统计学意义(P<0.05)。 结论 MIPPO技术是一种治疗肱骨干骨折的有效方法,具有创伤小、并发症少、骨折愈合快、肩肘关节功能影响小等优点。Abstract: Objective To investigate the effect of minimally invasive percutaneous plate osteosynthesis (MIPPO) in the treatment of humeral shaft fracture. Methods Total 16 patients with humeral shaft fracture admitted to the Department of Orthopedics, the First Affiliated Hospital of Bengbu Medical College from February 2015 to December 2019 were randomly divided into observation group and control group. The observation group was treated with MIPPO technology, and the control group was treated with open reduction and internal fixation with plate. The operation time, bleeding volume, incision length, postoperative complications, the time of fracture healing and upper extremity function in the last follow-up were compared between the two groups. Results The operation time, incision length, and bleeding volume in the observation group were lower than those in the control group with statistically significant difference. The hospitalization time in the observation group was lower than that in the control group, but the difference was not statistically significant. In the observation group, all cases were going without complications happened, such as infection, radial nerve injury. Otherwise in the control group, there were 1 case of incision fat liquefaction, 1 case of radial nerve injury symptoms after operation, all improved after symptomatic treatment. In the two groups, all fractures were healed, but the average healing time of the observation group was lower than the control group with the statistical significant difference. At the last follow-up, the DASH score of the observation group were lower than the control group with the statistical significant difference. Conclusion MIPPO is an effective method for the treatment of humeral shaft fracture, and worthy of clinical application.
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