Zhiquan An, Bingfang Zeng, Yeming Wang, Chi Zhang, Peiyan Huang
Department of Orthopedics, Affiliated No. 6th People's Hospital, Shanghai Jiaotong University, Shanghai, PR China.
J Orthop Trauma. 2007 Oct;21(9):628-33. doi: 10.1097/BOT.0b013e31815928c2.
To evaluate the clinical, radiographic, and functional outcomes of middle and distal third humeral shaft fractures treated with the minimally invasive percutaneous osteosynthesis (MIPO).
Prospective, single-center, nonconsecutive clinical series study.
: Skeletal trauma center of a university teaching hospital.
Thirteen patients who were seen from May 2004 to October 2005 with an average age of 38.1 years (range, 25 to 60 years) form the basis of this study. Patients were obtained from a surgical database of 1 surgeon.
The middle and the distal third humeral shaft fractures were reduced by closed means and fixed with long narrow 4.5-mm dynamic compression plates introduced through 2 small incisions away from the fracture sites and placed on the anterior aspect of the humerus.
Time to fracture healing and functional assessments were assessed at an average follow-up of 12.5 months (range, 7 to 19 months) for the affected shoulders and elbows using the UCLA and Mayo elbow performance scoring systems, respectively.
All fractures united with a mean healing time of 16.2 weeks (range, 12 to 32 years). There were no nonunions, radial nerve palsies, or implant failures. The UCLA scoring system showed excellent results in 7 cases (53.8%) and good results in 6 cases (46.2%). Thirteen patients had excellent results of their elbow function when assessed with the Mayo elbow performance scoring system.
Closed reduction and internal fixation of middle or distal third humeral shaft fractures using MIPO is a safe and effective surgical treatment method and an alternative option to open techniques.
评估采用微创经皮钢板接骨术(MIPO)治疗肱骨干中下段骨折的临床、影像学及功能预后。
前瞻性、单中心、非连续性临床系列研究。
一所大学教学医院的骨创伤中心。
2004年5月至2005年10月间就诊的13例患者,平均年龄38.1岁(范围25至60岁),构成了本研究的基础。患者来自1名外科医生的手术数据库。
采用闭合方法复位肱骨干中下段骨折,通过远离骨折部位的2个小切口插入长而窄的4.5毫米动力加压钢板并固定于肱骨前方。
分别采用加州大学洛杉矶分校(UCLA)和梅奥肘关节功能评分系统,对患肩和患肘进行平均12.5个月(范围7至19个月)的随访,评估骨折愈合时间和功能。
所有骨折均愈合,平均愈合时间为16.2周(范围12至32周)。无骨不连、桡神经麻痹或内固定失败情况。UCLA评分系统显示,7例(53.8%)结果为优,6例(46.2%)为良。采用梅奥肘关节功能评分系统评估时,13例患者的肘关节功能结果为优。
使用MIPO对肱骨干中下段骨折进行闭合复位内固定是一种安全有效的手术治疗方法,也是开放技术的一种替代选择。