肩峰前外侧入路MIPPO结合PHILOS钢板治疗肱骨近端骨折的疗效

Effect of proximal humeral fracture by anterolateral acromion approach MIPPO combined with PHILOS

目的探讨肩峰前外侧入路MIPPO结合PHILOS钢板治疗肱骨近端骨折的疗效。方法选取2015年3月至2018年2月在本院经肩峰前外侧入路MIPPO技术结合肱骨近端内固定锁定系统(PHILOS钢板)治疗的肱骨近端骨折患者58例,术后通过测量肩关节活动度、Neer肩关节评分标准对患者术后肩关节功能恢复情况进行评定;术后疼痛情况运用视觉模拟评分(VAS)进行评估,同时记录术后并发症发生情况。结果术后患者肩关节活动度:前屈平均161°,外展平145°,外旋平均70°。Neer评分平均91.7分。VAS评分平均2.13分。最终的功能结果,优43例,良13例,差2例,优良率为96.6%。所有患者术后最终骨折愈合时间为平均4.1个月。结论肩峰前外侧入路MIPPO技术结合PHILOS钢板治疗肱骨近端骨折的手术方式优势明显,MIPPO技术术中对骨折端的血供破坏少、PHILOS钢板对移位骨折的固定牢固、术后康复功能锻炼早期即可进行,是一种安全、微创、有效的治疗方法。

Objective To investigate the effect of anterolateral acromion approach MIPPO combined with PHILOS in the treatment of proximal humeral fractures. Methods From March 2015 to February 2018, 58 cases of proximal humeral fractures in our hospital were treated by MIPPO combined with PHILOS, the shoulder joint function was evaluated by shoulder joint mobility and neer shoulder joint score after operation. Pain was assessed by visual analogue scale(VAS) and complications were recorded. Results The average range of motion of shoulder joint was 161°in anteflexion, 145°in abduction and 70°in externa rotation. Neer score averaged 91.7 scores. The average VAS score was 2.13 scores. The final functional results: excellent was 43 cases, good was 13 cases and poor was 2 cases, the excellent and good rate was 96.6%. Bone healing was achieved in all patients at an average of 4.1 months. Conclusion MIPPO combined with PHILOS via anterolateral acromion approach is a safe, minimally invasive and effective method for the treatment of proximal humeral fractures, with less damage to local blood supply, firm fixation and early functional exercise after operation.