| 正骨手法结合经皮锁定钢板固定治疗老年肱骨近端骨折的病例对照研究 |
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Received:September 04, 2014
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| 作者 | Author | 单位 | Unit | E-Mail |
| 高益斌 |
GAO Yi-bin |
慈溪市人民医院骨科, 浙江 慈溪 310053 |
Department of Orthopaedics, People's Hospital of Cixi, Cixi 310053, Zhejiang, China |
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| 童松林 |
TONG Song-lin |
慈溪市人民医院骨科, 浙江 慈溪 310053 |
Department of Orthopaedics, People's Hospital of Cixi, Cixi 310053, Zhejiang, China |
13806646388@163.com |
| 虞建浩 |
YU Jian-hao |
慈溪市人民医院骨科, 浙江 慈溪 310053 |
Department of Orthopaedics, People's Hospital of Cixi, Cixi 310053, Zhejiang, China |
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| 陆文杰 |
LU Wen-jie |
慈溪市人民医院骨科, 浙江 慈溪 310053 |
Department of Orthopaedics, People's Hospital of Cixi, Cixi 310053, Zhejiang, China |
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| 期刊信息：《中国骨伤》2015年28卷，第4期，第335-339页 |
| DOI：10.3969/j.issn.1003-0034.2015.04.010 |
| 基金项目:浙江省中医药优秀青年人才基金计划(编号:2012ZQ025) |
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目的:探讨正骨手法闭合复位结合经皮微创固定治疗老年肱骨近端骨折的临床研究。
方法:2012年2月至2013年12月,收治老年肱骨近端骨折共39例,男17例,女22例;年龄67～88岁,平均(71.8±5.2)岁。分为经皮微创锁定钢板固定治疗组(MIPPO组)和切开复位锁定钢板内固定治疗组(ORIF组).MIPPO组21例,男11例,女10例;平均年龄(70.0±5.3)岁;术中先用正骨手法闭合复位肱骨近端,位置满意后经皮锁定钢板固定治疗。ORIF组18例,男10例,女8例;平均年龄(72.0±4.2)岁;采取经三角肌胸大肌间隙入路,切开复位骨折后锁定钢板内固定治疗。记录两组患者的手术时间、术中出血量、骨折愈合时间及术后并发症。末次随访时应用Constant-Murley评分系统对患肩进行评定。
结果:39例均获随访,时间11～27个月,平均18.1个月。MIPPO组平均出血量(176.0±57.4) ml,少于ORIF组的(356.0±66.9) ml;MIPPO组手术时间平均(47.4±14.9) min,短于ORIF组的(92.7±15.8) min;MIPPO组骨折愈合时间平均(17.6±5.8)周,短于ORIF 组的(21.7±4.9)周。肩关节功能Constant-Murley评分,MIPPO组89.7±14.5,优于ORIF组的81.8±13.2.
结论:正骨手法整复微创锁定钢板固定治疗肱骨近端骨折,具有创伤小、血供破坏少、固定可靠等优点,是治疗老年性肱骨近端骨折的有效方法。 |
| [关键词]:肱骨骨折 骨折固定术 外科手术,微创性 病例对照研究 |
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| Case control study on open reduction internal fixation (ORIF) and minimally invasive percutaneous plate osteosynthesis (MIPPO) for the treatment of proximal humerus fractures in aged |
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Abstract:
Objective:To investigate the clinical effects of close reduction and minimally invasive percutaneous plate osteosynthesis in treating proximal humerus fractures in the aged.
Methods:From February 2012 to December 2013, 39 patients with proximal humerus fractures were treated with minimally invasive percutaneous plate osteosynthesis (MIPPO group, 21 cases) and open reduction internal fixation (ORIF group, 18 cases). Including 17 males and 22 females in the study, and aged from 67 to 88 years old with an average of (71.8±5.2) years old. In MIPPO group, there were 11 males and 10 females with an average age of (70.0±5.3) years old;and in ORIF group, there were 10 males and 8 females with an average age of (72.0±4.2) years old. Operation time, blood loss during operation, fracture healing time and postoperative complications were recorded. The functions of the shoulder joints were assessed according to Constant-Murley score at final follow-up.
Results:All the patients were followed up from 11 to 27 months with an average of 18.1 months. The mean blood loss of the MIPPO group was (176.0±57.4) ml, while the ORIF group was (356.0±66.9) ml(t=7.22, P=0.01). The operation time of the MIPPO group was (47.4±14.9) min, while the ORIF group was (92.7±15.8) min(t=0.79, P=0.03). Fracture healing time in the MIPPO group and ORIF group was (17.6±5.8), ( 21.7±4.9) weeks, respectively (P<0.05). The mean Constant-Murley score at final follow-up was 89.7±14.5 in MIPPO group, and 81.8±13.2 in ORIF group (P<0.05).
Conclusion:MIPPO has advantages of little trauma, less blood loss, rapid recovery, less vascular damage and so on and can effectively treat the proximal humerus fracture in the aged. |
| KEYWORDS:Humeral fractures Fracture fixation Surgical procedures,minimally invasive Case-control studies |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 高益斌,童松林,虞建浩,陆文杰.正骨手法结合经皮锁定钢板固定治疗老年肱骨近端骨折的病例对照研究[J].中国骨伤,2015,28(4):335~339 |
| 英文格式: | GAO Yi-bin,TONG Song-lin,YU Jian-hao,LU Wen-jie.Case control study on open reduction internal fixation (ORIF) and minimally invasive percutaneous plate osteosynthesis (MIPPO) for the treatment of proximal humerus fractures in aged[J].zhongguo gu shang / China J Orthop Trauma ,2015,28(4):335~339 |
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