MIPPO技术应用于肱骨中段粉碎性骨折患者的临床疗效及对肘关节评分的影响

Clinical efficacy of MIPPO technique in patients with comminuted fracture of middle humerus and its influence on elbow score

目的:探讨选用经皮微创锁定钢板内固定术(MIPPO)治疗肱骨中段粉碎性骨折患者的效果及对肘关节评分的影响。方法:将50例肱骨中段粉碎性骨折患者按随机数字表分为对照组(25例,治疗传统切开复位内固定术)、观察组(25例,治疗MIPPO),观察患者肘关节功能评分(Mayo)、手术指标、肩关节功能评分(CMS)、临床疗效以及并发症等。结果:两组手术时间对比差异无统计学意义(P>0.05);术后观察组患者Mayo评分均较对照组显著更高,观察组术中出血量及愈合时间均较对照组更少,差异有统计学意义(P<0.05);术后观察组肩部疼痛、日常活动、肩关节活动范围以及肌力等均高于对照组,差异有统计学意义(P<0.05);两组治疗总有效率分别为60.00%、88.00%,观察组显著更高,不良反应总发生率分别为24.00%、4.00%,观察组显著更低,差异有统计学意义(P<0.05)。结论:肱骨中段粉碎性骨折患者临床治疗中选用MIPPO,可明显提高患者肘关节与肩关节功能改善效果,且手术安全性更高,并能提升骨伤愈合速度,获得更理想的治疗有效性。

Objective To investigate the effect of minimally invasive percutaneous locking plate osteosynthesis(MIPPO)in the treatment of comminuted fracture of middle humerus and its influence on elbow score.Method 50 patients with comminuted fracture of middle humerus were randomly divided into control group(25 cases,traditional open reduction and internal fixation)and observation group(25 cases,percutaneous minimally invasive locking plate internal fixation).Elbow function score,operation index,shoulder function score,clinical efficacy and complications were observed.Results There was no significant difference in the operation time between the two groups(P>0.05);the Mayo score of the observation group was significantly higher than that of the control group,the intraoperative blood loss and healing time of the observation group were less than those of the control group(P<0.05);the shoulder pain,daily activities,shoulder joint range of motion and muscle strength of the observation group were higher than those of the control group(P<0.05);the total effective rate of the two groups was 60.00%and 88.00%respectively,which was significant higher in the observation group,the total incidence of adverse reactions was 24.00%and 4.00%respectively,which was significantly lower in the observation group(P<0.05).Conclusion In the clinical treatment of comminuted fracture of middle humerus,percutaneous minimally invasive locking plate internal fixation can significantly improve the function of elbow and shoulder joint,and has higher safety,and can improve the healing speed of bone injury,and obtain more ideal treatment effectiveness.