摘要
目的比较B超体表定位上臂神经结合经皮微创钢板内固定(MIPPO)技术与单纯MIPPO技术治疗肱骨干中上段骨折的疗效。方法回顾性分析2015年8月至2017年5月西安市红会医院创伤骨科收治的105例肱骨干中上段骨折患者资料。根据是否使用B超体表定位上臂神经将患者分为2组:联合组52例(采用B超体表定位上臂神经结合MIPPO技术治疗),单纯组53例(采用单纯MIPPO技术治疗)。记录并比较两组患者的手术时间、术中失血量、骨折愈合时间与并发症发生率。末次随访时采用Neer肩关节功能评分评估肩关节功能。结果联合组与单纯组患者术前一般资料比较差异均无统计学意义(P>0.05),具有可比性。联合组与单纯组手术时间分别为(62.8±8.6)、(96.8±7.5)min,术中失血量分别为(107.4±5.6)、(215.4±7.2)mL,以上项目两组间比较差异均有统计学意义(P<0.05)。末次随访时Neer肩关节功能评分结果显示:联合组优良率[94.2%(49/52)]显著高于单纯组[81.1%(43/53)],差异有统计学意义(P<0.05)。结论对于肱骨干中上段骨折,采用MIPPO技术治疗术前应常规进行上臂神经B超定位,可以减少手术时间和术中失血量,改善预后功能。
Objective To compare the minimally invasive plate osteosynthesis(MIPPO)with versus without B-ultrasound surface localization of the upper arm nerves in the treatment of fractures of the middle and upper humeral shaft.Methods A retrospective analysis was conducted of the 105 patients who had been admitted to Department of Orthopaedic Trauma,Honghui Hospital for fractures of the middle and upper humeral shaft from August 2015 to May 2017.They were divided into 2 groups according to whether or not B-ultrasound surface localization of the upper arm nerves had been used in MIPPO.There were 52 cases in the B-ultrasound localization group and 53 cases in the simple MIPPO group.The 2 groups were compared in terms of operation time,intraoperative blood loss,fracture union time and complications.The shoulder joint functions were assessed at the last follow-up using the Neer shoulder joint function scoring.Results There was no significant difference in the preoperative general data between the 2 groups,showing comparability between groups(P>0.05).There were significant differences between the B-ultrasound localization group and the simple MIPPO group in operation time[(62.8±8.6)min versus(96.8±7.5)min],or intraoperative blood loss[(107.4±5.6)mL versus(215.4±7.2)mL].Neer shoulder function scoring showed that the excellent and good rate in the B-ultrasound localization group[94.2%(49/52)]was significantly higher than that in the simple MIPPO group[81.1%(43/53)](P<0.05).Conclusions In the MIPPO of fractures of the upper and middle humeral shaft,B-ultrasound surface localization of the upper arm nerves should be used as preoperative routines to reduce operation time and intraoperative blood loss to improve prognostic functions of the shoulder.
作者
樊伟
宋哲
王晨
王晓龙
张堃
朱养均
衡立松
Fan Wei;Song Zhe;Wang Chen;Wang Xiaolong;Zhang Kun;Zhu Yangjun;Heng Lisong(Department of Orthopaedic Trauma,Honghui Hospital,Xi'an 710054,China)
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2021年第8期669-673,共5页
Chinese Journal of Orthopaedic Trauma
关键词
肱骨骨折
超声检查
骨折固定术
内
上臂神经
Humeral fractures
Ultrasonography
Fracture fixation,internal
Upper arm nerve
