摘要
目的探讨应用经皮微创钢板接骨技术（MIPPO）加植骨治疗老年肱骨近端Neer三、四部分骨折的临床效果。方法经三角肌前外侧入路，MIPPO技术加植骨治疗38例老年肱骨近端Neer三、四部分骨折（三部分骨折32例，四部分骨折6例）。观察肩关节活动范围、肌力、疼痛情况，肩关节功能采用Con．stant-Murley肩关节评分评定疗效。结果术后随访12～36个月，平均19．2个月，所有患者骨折均愈合，平均愈合时间16．3周。无伤口感染，无钢板螺钉断裂和内固定松动，肱骨头坏死1例。术后功能根据Con-stant-Murley肩关节评分，优27例，良7例，可4例；优良率为89．5％。结论MIPPO技术加植骨老年肱骨近端Neer三、四部分骨折体现间接复位、微创、生物学固定理念，是一种可靠、有效的治疗方法。
Objective To explore the clinical significance of minimally invasive percutaneous plate osteo- synthesis （ MIPPO ） techniques combined with bone grafting in treating Neer three-part or four-part proximal humeral fractures in elderly patients. Methods A total of 38 elderly patients with proximal humeral fractures were treated with MIPPO techniques combined with bone grafting by the anterior-lateral deltoid approach. According to the Neer classification,32 cases were three-part fractures and 6 cases were four-part fractures. The shoulder joint activity, muscle strength ,pain degree of the 38 patients were observed and their shoulder functions were evaluated by the Constant-Murley scoring system. Results The follow up period ranged from 12 to 36 months （ averaging 19. 2 months）. Bone union was achieved in all the cases,and the average time for bony union was 16. 3 weeks. There was no infection, no screw or plate breakage and no fixation loosening. There was 1 ease of avaseular necrosis of the humeral head. Postoperative shoulder function scores evaluated by Constant-Murley scoring system showed excellent in 27 cases,good in 7 cases and fair in 4 cases. The excellent and good rate was 89.5%. Conclusion MIPPO techniques combined with bone grafting for treating Neer three-part or four-part proximal humeral fractures in the elderly patients is a kind of reliable and effective treatment method, which follows the principles of indirect reduc- tion, minimal invasiveness and biological fixation.
出处
《创伤外科杂志》
2013年第6期504-506,共3页
Journal of Traumatic Surgery
关键词
肱骨骨折
植骨
钢板接骨术
老年
humeral fractures
bone graft
plate osteosynthesis
elderly
