前侧入路MIPO技术LCP内固定治疗肱骨干中下段骨折

Mid-distal humeral shaft fractures treated by minimally invasive plate osteosynthesis combined with LCP through anterior approach

目的探讨采用前侧入路微创钢板接骨术（MIPO）结合锁定加压钢板（LCP）内固定治疗肱骨干中下段骨折的安全性与疗效。方法回顾性分析自2012-01—2014—06采用前侧入路MIPO技术结合锁定加压钢板（LCP）内固定治疗肱骨干中下段骨折16例。末次随访时按Constant-Murley肩关节评分系统评定肩关节功能，按改良Mayo肘关节功能评分系统评定肘关节功能。结果本组手术时间75～110rain，平均92min；术中出血量50～150ml。平均75ml。16例均获得随访，随访时间6～24个月，平均12．3个月。骨折均于术后3～4个月临床愈合，平均3．4个月。所有患者骨折均愈合，无内固定失败、医源性桡神经和肌皮神经损伤。末次随访时Constant—Mudey肩关节评分平均95．3分，改良Mayo肘关节功能评分平均93-3分，16例功能评价均达优。结论采用前侧入路MIPO技术结合LCP内固定治疗肱骨干中下段骨折具有固定可靠、创伤小、保护血供、神经安全、骨折愈合率高、并发症少、功能恢复佳等优点，完全符合骨折治疗理念中的生物学固定原则．可成为治疗肱骨干中下段骨折较理想的手术方法。

Objective To evaluate the clinical effects and safety of minimally invasive plate osteosynthesis （MIPO） combined with locking compression plate （LCP） in the treatment of mid-distal humeral shaft fractures through anterior approach. Methods From January 2012 to June 2014, 16 patients with mid-distal humeral fractures were treated by MIPO combined with LCP through anterior approach. The function of the shoulder and elbow were evaluated by Constant-Mudey assessment of the shoulder and An-Morrey Mayo assessment of the elbow. Results The operative time was 75 to 110 rain（average, 92 min）, the blood loss on surgical treatment was 50 to 150 ml （average, 75 ml）. All the patients were followed up for 6-24 months （average 12.3 months）. Bone healing was observed in all patients and there were no implant failure and intragenic secondary injury to radial nerve. All the patients had good function of shoulder and elbow, got a mean score of 95.3 according to Constant-Murley assessment of the shoulder and 93.3 according to An-Morrey Mayo assessment of the elbow. Conclusion There are many advantages in the treatment of mid-distal humeral shaft fractures by minimally invasive plate osteosynthesis combined with LCP through anterior approach, such as fewer complications, better functional recovery. It completely conforms to today＇s philosophy of biological osteosynthesis. It can be an ideal surgical procedure in the treatment of mid-distal humeral shaft fractures.