Objective:To study the effects of MIPO and ORIF on stress degree and bone metabolism activity in patients with middle humeral shaft fractures.Methods: Patients with middle humeral shaft fractures who received surgical...Objective:To study the effects of MIPO and ORIF on stress degree and bone metabolism activity in patients with middle humeral shaft fractures.Methods: Patients with middle humeral shaft fractures who received surgical treatment in Mianyang Orthopedic Hospital between June 2010 and October 2015 were enrolled and randomly divided into MIPO group and ORIF group who were treated with minimally invasive plate oateosynthesis and open reduction internal fixation respectively. Before surgery as well as 1 d and 3 d after surgery, serum was collected to determine the contents of stress response molecules and bone metabolism markers.Results:1 d and 3 d after surgery, serum stress molecules PGE2, CRP, NE and E as well as bone resorption markers TRACP-5B,β-CTX, RANK and RANKL contents of both groups were higher than those before surgery while bone formation markers BGP, BALP, PINP and OPG contents were lower than those before surgery;serum stress molecules PGE2, CRP, NE and E as well as bone resorption markers TRACP-5B,β-CTX, RANK and RANKL contents of MIPO group were lower than those of ORFI group while bone formation markers BGP, BALP, PINP and OPG contents were higher than those of ORFI group.Conclusion: Compared with ORIF, MIPO for middle humeral shaft fractures can reduce stress response degree and improve bone metabolism.展开更多
Background Accurate and precise preoperative planning can provide information instrumental for performing less invasive articular fracture surgery. The purpose of this study was to determine that computer-assisted pre...Background Accurate and precise preoperative planning can provide information instrumental for performing less invasive articular fracture surgery. The purpose of this study was to determine that computer-assisted preoperative planning (CAPP) has the potential to improve efficiency and time in the operating room. Methods Sixty-four patients with proximal humeral fractures were treated using locking plates by minimally invasive plate osteosynthesis (MIPO) with CAPP. The time needed for virtual segmentation, reduction, and fixation of the fracture fragments were recorded. Intra and interobserver reliabilities were analyzed using the intraclass correlation coefficient. The clinical function was analyzed using Constant Score and radiology. Results The mean total time required for CAPP of two-part, three-part, and four-part proximal humeral fractures were (13.63±1.38) minutes, (23.14±2.18) minutes, and (39.61±3.01) minutes, respectively. The intra and interobserver reliabilities for all variables were high, ranging from 0.785 to 0.992. The mean operation time was (50.1±6.7) minutes. Fifty- two patients were followed up with an average time of 34.2 months. The mean Constant Score of the injury side was (82.5 ± 9.9). Three of the fifty-two patients had four complications. Conclusion The application of CAPP was efficient and reliable, and provided excellent clinical and radiographic outcomes for the treatment of proximal humerus fractures by MIPO.展开更多
目的探讨经三角肌入路手法复位微创技术(MIPO)对老年肱骨近端骨折的肩关节功能及生活质量的影响。方法回顾性分析湖北医药学院附属随州医院骨三科2016年1月至2017年12月收治的60例老年肱骨近端骨折患者的临床治疗资料,根据资料中手术方...目的探讨经三角肌入路手法复位微创技术(MIPO)对老年肱骨近端骨折的肩关节功能及生活质量的影响。方法回顾性分析湖北医药学院附属随州医院骨三科2016年1月至2017年12月收治的60例老年肱骨近端骨折患者的临床治疗资料,根据资料中手术方式不同,将经三角肌入路手法复位微创技术治疗的30例患者作为微创组,30例行传统胸三角肌入路切开复位锁定钢板内固定手术者作为传统组。比较两组患者的手术时间、切口长度、术中出血量、术后肩关节疼痛情况、肩关节功能恢复及生活质量。结果微创组患者的手术时间、术中出血量、切口长度均低于传统组[(82.15±18.69) min vs (176.69±89.61) min,(145.69±45.36) mL vs (180.17±56.69) mL,(8.05±1.36) cm vs (11.74±1.79) cm],差异均具有统计学意义(P<0.05);两组患者手术后肩关节VAS疼痛评分呈现逐渐下降趋势,且微创组患者术后7 d、术后3个月、术后6个月时VAS疼痛评分均明显低于传统组[(4.76±0.69)分vs(5.31±0.79)分,(2.89±0.56)分vs (3.31±0.89)分,(1.01±0.12)分vs (1.34±0.62)分],差异均具有统计学意义(P<0.05);微创组患者术后1个月、术后3个月时Constant-Murley评分明显高于传统组[(69.69±7.12)分vs (63.58±5.63)分,(76.79±5.12)分vs (67.62±6.46)分],差异均具有统计学意义(P<0.05);微创组患者术后1个月、术后3个月时EQ-5D健康指数明显高于传统组[(0.52±0.07) vs (0.40±0.12),(0.79±0.02) vs (0.61±0.05)],差异均具有统计学意义(P<0.05)。结论相对于传统入路锁定钢板内固定手术,经三角肌入路手法复位微创技术治疗老年肱骨近端骨折更能提高患者的肩关节功能,改善其生活质量,值得临床推广。展开更多
文摘Objective:To study the effects of MIPO and ORIF on stress degree and bone metabolism activity in patients with middle humeral shaft fractures.Methods: Patients with middle humeral shaft fractures who received surgical treatment in Mianyang Orthopedic Hospital between June 2010 and October 2015 were enrolled and randomly divided into MIPO group and ORIF group who were treated with minimally invasive plate oateosynthesis and open reduction internal fixation respectively. Before surgery as well as 1 d and 3 d after surgery, serum was collected to determine the contents of stress response molecules and bone metabolism markers.Results:1 d and 3 d after surgery, serum stress molecules PGE2, CRP, NE and E as well as bone resorption markers TRACP-5B,β-CTX, RANK and RANKL contents of both groups were higher than those before surgery while bone formation markers BGP, BALP, PINP and OPG contents were lower than those before surgery;serum stress molecules PGE2, CRP, NE and E as well as bone resorption markers TRACP-5B,β-CTX, RANK and RANKL contents of MIPO group were lower than those of ORFI group while bone formation markers BGP, BALP, PINP and OPG contents were higher than those of ORFI group.Conclusion: Compared with ORIF, MIPO for middle humeral shaft fractures can reduce stress response degree and improve bone metabolism.
文摘Background Accurate and precise preoperative planning can provide information instrumental for performing less invasive articular fracture surgery. The purpose of this study was to determine that computer-assisted preoperative planning (CAPP) has the potential to improve efficiency and time in the operating room. Methods Sixty-four patients with proximal humeral fractures were treated using locking plates by minimally invasive plate osteosynthesis (MIPO) with CAPP. The time needed for virtual segmentation, reduction, and fixation of the fracture fragments were recorded. Intra and interobserver reliabilities were analyzed using the intraclass correlation coefficient. The clinical function was analyzed using Constant Score and radiology. Results The mean total time required for CAPP of two-part, three-part, and four-part proximal humeral fractures were (13.63±1.38) minutes, (23.14±2.18) minutes, and (39.61±3.01) minutes, respectively. The intra and interobserver reliabilities for all variables were high, ranging from 0.785 to 0.992. The mean operation time was (50.1±6.7) minutes. Fifty- two patients were followed up with an average time of 34.2 months. The mean Constant Score of the injury side was (82.5 ± 9.9). Three of the fifty-two patients had four complications. Conclusion The application of CAPP was efficient and reliable, and provided excellent clinical and radiographic outcomes for the treatment of proximal humerus fractures by MIPO.
文摘目的探讨经三角肌入路手法复位微创技术(MIPO)对老年肱骨近端骨折的肩关节功能及生活质量的影响。方法回顾性分析湖北医药学院附属随州医院骨三科2016年1月至2017年12月收治的60例老年肱骨近端骨折患者的临床治疗资料,根据资料中手术方式不同,将经三角肌入路手法复位微创技术治疗的30例患者作为微创组,30例行传统胸三角肌入路切开复位锁定钢板内固定手术者作为传统组。比较两组患者的手术时间、切口长度、术中出血量、术后肩关节疼痛情况、肩关节功能恢复及生活质量。结果微创组患者的手术时间、术中出血量、切口长度均低于传统组[(82.15±18.69) min vs (176.69±89.61) min,(145.69±45.36) mL vs (180.17±56.69) mL,(8.05±1.36) cm vs (11.74±1.79) cm],差异均具有统计学意义(P<0.05);两组患者手术后肩关节VAS疼痛评分呈现逐渐下降趋势,且微创组患者术后7 d、术后3个月、术后6个月时VAS疼痛评分均明显低于传统组[(4.76±0.69)分vs(5.31±0.79)分,(2.89±0.56)分vs (3.31±0.89)分,(1.01±0.12)分vs (1.34±0.62)分],差异均具有统计学意义(P<0.05);微创组患者术后1个月、术后3个月时Constant-Murley评分明显高于传统组[(69.69±7.12)分vs (63.58±5.63)分,(76.79±5.12)分vs (67.62±6.46)分],差异均具有统计学意义(P<0.05);微创组患者术后1个月、术后3个月时EQ-5D健康指数明显高于传统组[(0.52±0.07) vs (0.40±0.12),(0.79±0.02) vs (0.61±0.05)],差异均具有统计学意义(P<0.05)。结论相对于传统入路锁定钢板内固定手术,经三角肌入路手法复位微创技术治疗老年肱骨近端骨折更能提高患者的肩关节功能,改善其生活质量,值得临床推广。