MIPO技术与交锁髓内钉治疗肱骨干骨折的疗效分析
| 作 者：余浩, 沈黎明, 罗顺红, 秧茂盛, 赵飒, 刘满花, 蒲丹 |
| 单 位：吉首大学医学院 |
| 基金项目：湖南省教育厅科学研究项目 |
| 摘 要： |
| 探讨经皮微创接骨板内固定术（ minimally invasive percutaneous plate osteosynthesis，MIPO）与交锁髓内钉（locked intramedullary nail， LIN）治疗肱骨干骨折的临床疗效。方法：分别选取2019年5月～2021年5月新鲜肱骨干骨折患者34例，根据术前充分告知，其中17例接受MIPO手术（MIPO组），17例接受LIN手术(LIN组)。比较两组手术时间、住院时间、骨折愈合时间、术中出血量、术中C臂透视次数、并发症发生率、肘关节Mayo评分及肩关节Neer评分。结果：术后34例患者获12-28个月随访，平均随访时间16.3月。两组手术时间、住院时间、术中出血量、骨折愈合时间及肘关节Mayo评分比较，差异均无统计学意义（P0.05）。MIPO组术后出现1例肌皮神经损伤，LIN组术后出现了6例肩关节疼痛及活动障碍；MIPO组术后肩关节功能Neer评分高于LIN组，总并发症发生率低于LIN组，差异有统计学意义（P＜0.05）。MIPO组术中C型臂X线透视次数明显少于LIN组，差异有统计学意义（P＜0.05）。结论：MIPO与LIN均是治疗肱骨干骨折的有效方法，但MIPO在肩关节功能恢复、降低肩关节并发症和减少术者射线暴露时间上更优。 |
| 关键词：肱骨干骨折；髓内钉；MIPO；内固定 |
Analysis of the effect of MIPO and locked intramedullary nail on humeral shaft fracture
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| Abstract: |
| Explore minimally invasive percutaneous plate osteosynthesis (MIPO) and locked intramedullary nail, minimally invasive percutaneous plate osteosynthesis (MIPO) Clinical efficacy of LIN in the treatment of humeral shaft fracture. Methods: 34 patients with fresh humeral shaft fractures were selected from May 2019 to May 2021. According to the preoperative information, 17 patients received MIPO operation (MIPO group) and 17 patients received LIN operation (LIN group). Operation time, hospital stay, fracture healing time, intraoperative blood loss, intraoperative C-arm fluoroscopy times, complication rate, elbow Mayo score and shoulder Neer score were compared between the two groups. Results: 34 patients were followed up for 12-28 months, with an average follow-up time of 16.3 months. There were no significant differences in operation time, hospital stay, intraoperative blood loss, fracture healing time and elbow Mayo score between the two groups (P＞0.05). There were 1 case of musculocutaneous nerve injury in MIPO group and 6 cases of shoulder joint pain and mobility disorder in LIN group. The Neer score of postoperative shoulder joint function in MIPO group was higher than that in LIN group, and the incidence of total complications was lower than that in LIN group, with statistical significance (P 0.05). The number of C-arm fluoroscopy in MIPO group was significantly lower than that in LIN group, and the difference was statistically significant (P 0.05). Conclusion: MIPO and LIN are both effective methods in the treatment of humeral shaft fracture, but MIPO is better in the recovery of shoulder joint function, the reduction of shoulder joint complications and the reduction of radiation exposure time. |
| Keywords: Humeral shaft fracture; Intramedullary nail; MIPO; Internal fixation |
| 投稿时间：2023-11-08 |
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