前外侧微创钢板内固定治疗肱骨干远端骨折

Anterolateral minimally invasive plate osteosynthesis technique for distal humeral shaft fracture

目的:评价前外侧入路微创钢板内固定技术(minimally invasive plate osteosynthesis,MIPO)治疗肱骨干远端骨折的临床疗效,并对该技术可行性、安全性及优缺点进行探讨。方法:回顾性分析17例接受该技术治疗的肱骨干远端骨折患者的临床疗效,记录其手术时间、出血量、并发症、骨折愈合时间、肘关节活动度;采用Mayo肘关节功能评分标准(Mayo elbow performance score,MEPs)对肘关节功能进行评价,并测量骨折愈合后肱骨是否遗留成角畸形。结果:17例患者均获得骨性愈合,平均愈合时间为19.2周,远端固定螺钉平均为4.5枚,肘关节活动范围平均为133°,MEPs评分平均为98.2分,7例患者存在内翻畸形,平均内翻角度为8.3°。结论:前外侧入路MIPO治疗肱骨干远端骨折安全、有效,临床疗效满意,但部分患者可能存在内翻畸形。

Objective: To evaluate the clinical effcacy of the modiifed anterolateral minimally invasive plate osteosynthesis technique for distal humeral shaft fracture, and to explore its feasibility, security, advantage and disadvantage. Methods: hTe clinical effcacy of 17 patients with distal humeral shatf fracture, who were treated with the anterolateral humerus minimally invasive plate osteosynthesis during 2009 to 2012, were retrospectively analyzed. hTe operative time, bleeding volume, complications, esseous union time and range of motion (ROM) of elbow were recorded, and the functional outcome of elbow joint was evaluated by Mayo elbow performance score (MEPs). The varus angle was measured in the malunion patients atfer the distal humeral shatf fracture healed. Results: All of the 17 patients obtained bony union at an average of 19.2 weeks postoperatively, an average of 4.5 screwes were inserted in distal humerus. hTe mean ROM of elbows was 133° and the MEPS were 98.2. Seven patients suffered humeral malalignment and the mean varus degrees were 8.3°. Conclusion: hTe technique of anterolateral humerus minimally invasive plate osteosynthesis is safe and feasible for distal humeral shatf, and the satisfactory clinical outcomes can be obtained by this modiifed technique. However, some of the patients may appear malunion with varus angulation of humerus.