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肱骨远端三分之一骨干骨折的后路微创钢板接骨术(MIPO)及桡神经节段性分离

Posterior minimally invasive plate osteosynthesis (MIPO) of distal third humeral shaft fractures with segmental isolation of the radial nerve.

作者信息

Gallucci G L, Boretto J G, Alfie V A, Donndorff A, De Carli P

机构信息

Servicio de Ortopedia y Traumatología, Hospital Italiano de Buenos Aires, Perón 4190, CC1199ACK CABA Buenos Aires, Argentina.

出版信息

Chir Main. 2015 Oct;34(5):221-6. doi: 10.1016/j.main.2015.06.007. Epub 2015 Sep 19.

Abstract

UNLABELLED

The aim of this study was to evaluate the clinical, radiographic, and functional outcomes of a cohort of patients with distal third humeral shaft fractures treated using a posterior minimally invasive plate osteosynthesis (MIPO) technique. Twenty-one patients were retrospectively evaluated, 13 men and 8 women with an average age of 37 years. The surgery was performed through two posterior incisions away from the fracture site. The radial nerve was identified and protected. The fracture was fixed with a narrow 4.5/5.0mm locking compression plate. After an average follow-up of 22 months, flexion-extension of the elbow was 138°±7°, with a range of motion of 131°. Shoulder motion was 160° in forward flexion, 59° in external rotation, and internal rotation was to the spinous process of 9th thoracic vertebra. Pain severity was 0.5 on the VAS. The DASH score was 9. Average Constant score was 84. MEPI was 97. Fracture union was obtained in all patients. One patient developed transient postoperative radial nerve palsy. These results demonstrate that the posterior MIPO technique is a reliable option for treating distal third humeral shaft fractures.

LEVEL OF EVIDENCE

摘要

未标注

本研究的目的是评估一组采用后侧微创钢板接骨术(MIPO)治疗的肱骨干远端三分之一骨折患者的临床、影像学和功能结果。对21例患者进行了回顾性评估,其中男性13例,女性8例,平均年龄37岁。手术通过远离骨折部位的两个后侧切口进行。识别并保护桡神经。骨折用4.5/5.0mm窄锁定加压钢板固定。平均随访22个月后,肘关节屈伸角度为138°±7°,活动范围为131°。肩关节前屈角度为160°,外旋角度为59°,内旋至第9胸椎棘突。视觉模拟评分(VAS)疼痛严重程度为0.5。上肢功能障碍评分(DASH)为9分。Constant平均评分为84分。梅奥肘关节性能指数(MEPI)为97分。所有患者均获得骨折愈合。1例患者出现术后短暂性桡神经麻痹。这些结果表明,后侧MIPO技术是治疗肱骨干远端三分之一骨折的可靠选择。

证据级别

4级。

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