摘要
[目的]探讨采用MIPPO技术结合肱骨近端内固定锁定系统（PHILOS）治疗老年骨质疏松性肱骨近端骨折的疗效。[方法]回顾分析本院2009年4月～2012年5月具有完整随访资料的68例老年骨质疏松性肱骨近端骨折患者，其中采用MIPPO技术结合PHILOS治疗老年骨质疏松性肱骨近端骨折患者37例（MIPPO组），传统切开复位内固定（ORIF）PHILOS治疗老年骨质疏松性肱骨近端骨折患者31例（ORIF组）。记录切口长度、手术时间、出血量、住院天数，观察骨折愈合时间、功能恢复情况及并发症，并进行统计学分析。[结果]68例患者术后随访12～36个月（平均19．7个月），MIPPO组切口长度、手术时间、出血量、住院天数、骨折愈合时间等比较明显优于ORIF组，差异具有统计学意义（P〈0．05）；而功能恢复优良率及并发症发生率等比较MIPPO组优于ORIF组，但差异未见统计学意义（P〉0．05）。[结论]MIPPO技术结合PHILOS治疗老年骨质疏松性肱骨近端骨折符合生物学固定原则，较传统切开复位内固定方法具有轻微优势，如：创伤小、切口小、住院时间短、出血量少、手术时间短、骨折愈合早等优点，是治疗老年骨质疏松性肱骨近端骨折的有效方法。
[ Objective] This article discusses the clinical efficacy of minimally invasive percutaneous plate osteosynthesis （MIPPO） with use of the proximal humerus internal locking system （PHILOS） for osteoporotic proximal humerus fractures. [ Method] From April 2009 to May 2012, sixty - eight patients recieved surgery for osteoporotic proximal humerus fractures in out hospital. The patients were followed up for a mean of 19.7 （range from 12 to 36） months. The fractures were classified ac- conding to the Neer system. The patients were randomly arranged into the MIPPO （ n = 37 ） and the open reduction and internal fixation （ORIF） groups （n = 31 ）. The mean incision length, the operation time, blood loss, duration of hospital stay, time for fracture healing,function recovery, and complications were recorded and statistical analyzed. [ Result] MIPPO with use of PHI- LOS can achieve good curative effect for the treatment of senile osteoporotic proximal humerus fractures. There was a statistically significant difference between the two groups in regard to the mean incision length,operation time,blood loss, duration of hospital stay, and time taken for fracture healing. Twelve months after surgery, the MIPPO group showed a better functional recovery rate and fewer complications than the ORIF group, but the difference was not statistically significant （P 〉 0.05 ）. [ Conclusion ] MIPPO with use of PHILOS conforms to the biological fixation principles for the treatment of senile osteoporotic proximal hume- rus fractures. MIPPO also has a slight advantage compared to ORIF, such as lesser trauma, a smaller incision, shorter hospital stay ,less blood loss, shorter operative time, and early fracture healing. It is therefore a more effective way of treating senile osteo- porotic proximal humerus fractures.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2014年第6期508-511,共4页
Orthopedic Journal of China
