| 秦 潇,徐世保,范荣豪.MIPPO与ORIF治疗肱骨近端 NeerⅢ ~ Ⅳ型骨折疗效对比[J].中国烧伤创疡杂志,2023,(2):126~129. |
| DOI： |
| 中文关键词: 经皮微创接骨板内固定 切开复位内固定 肱骨近端骨折 Ｎｅｅｒ 分型 肩关节功能 |
| 英文关键词:Minimally invasive percutaneous plate osteosynthesis Open reduction and internal fixation Proximal humeral fracture Neer classification Shoulder joint function |
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| 中文摘要: |
| 【摘要】 目的 对比分析经皮微创接骨板内固定(MIPPO)与切开复位内固定(ORIF)治疗肱骨近端NeerⅢ～Ⅳ型骨折的临床疗效。方法 选取2019年8月至2021年8月焦作市人民医院收治的62例肱骨近端 NeerⅢ～Ⅳ型骨折患者作为研究对象, 按照不同治疗方法将其分为 MIPPO组(30例)与ORIF组(32例), MIPPO 组患者行 MIPPO 治疗, ORIF 组患者行ORIF治疗, 对比观察两组患者手术时间、术中出血量、骨折愈合时间及血清炎症因子水平、肩关节功能、临床疗效与并发症发生情况。结果 MIPPO 组患者手术时间及骨折愈合时间均明显短于ORIF组 (t = 5.052、4.588, P 均 < 0.001), 术中出血量明显少于 ORIF 组 ( t = 15.464, P < 0.001);术后3 d, MIPPO 组患者血清 C 反应蛋白 (CRP)、白细胞介素-6 (IL-6)和肿瘤坏死因子-α (TNF-α)水平均明显低于ORIF组(t = 7.603、5.277、22.438, P均< 0.001); 术后 6 个月, MIPPO 组患者Constant-Murley 肩关节评分量表 (CMS) 评分明显低于 ORIF 组 (t=5.323, P < 0.001); 术后6个月, MIPPO组患者临床疗效优良率为93.33% , 明显高于 ORIF 组患者的临床疗效优良率71.88% (χ2=4.885,P =0.027); MIPPO 组患者术后并发症发生率为 6.67%,与ORIF组患者的术后并发症发生率18.75%无明显差异 (χ2= 2.012, P = 0.156)。结论 与ORIF相比, MIPPO 治疗肱骨近端NeerⅢ~Ⅳ型骨折的临床疗效更佳,肩关节功能恢复效果更好, 临床应用价值更高。 |
| 英文摘要: |
| 【Abstract】 Objective To compare the clinical efficacy of minimally invasive percutaneous plate osteosynthesis (MIPPO) and open reduction and internal fixation (ORIF) in the treatment of Neer type Ⅲ - Ⅳ fracture at the proximal end of humerus. Methods 62 patients with proximal humeral fracture of Neer type Ⅲ - Ⅳ admitted to Jiaozuo People’s Hospital from August 2019 to August 2021 were enrolled as research subjects, and divided into MIPPO group (n = 30) and ORIF group (n = 32) according to different treatments they received. Patients in MIPPO group were treated with MIPPO,while ORIF was performed on patients in ORIF group. The following items, including operation time, intraoperative blood loss, fracture healing time, levels of serum inflammation factors, shoulder joint function, clinical efficacy, and occurrence of complications, were compared between the two groups. Results The operation time and fracture healing time of patientsin the MIPPO group were significantly shorter compared with the ORIF group (t = 5.052 and 4.588, both P < 0.001), and the intraoperative blood loss was significantly less ( t = 15.464, P < 0.001). At day 3 after surgery, the levels of serum C-reactive protein (CRP), interleukin-6 ( IL-6), and tumor necrosis factor-α ( TNF-α) of patients in the MIPPO group were obviously lower than that in the ORIF group (t = 7.603, 5. 277 and 22.438, all P < 0.001); at 6 months after surgery,the Constant-Murley scale (CMS) score of patients in the MIPPO group was significantly lower compared with the ORIF group (t = 5.323, P < 0.001); at 6 months after surgery, the good and excellent rate of patients was 93.33% in the MIPPO group, being significantly higher than 71.88% in the ORIF group ( χ2= 4.885, P = 0.027); the incidence of postoperative complications in the MIPPO group was 6.67% , showing no significant difference compared with the corre-sponding 18. 75% in the ORIF group (χ2= 2.012, P = 0.156). Conclusion Compared with ORIF, MIPPO can achieve better clinical efficacy in the treatment of proximal humeral fracture of Neer type Ⅲ - Ⅳ, with better recovery of shoulder joint function, and much high value of clinical application. |
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