临床骨科杂志2025，Vol.28Issue(1)：73-77,5.DOI:10.3969/j.issn.1008-0287.2025.01.023
两种手术方式治疗肱骨近端骨折的疗效比较
Comparison of effect of two surgical methods in the treatment of proximal humerus fractures
摘要
Abstract
Objective To compare the efficacy of minimally invasive percutaneous plate osteosynthesis(MIPPO)and traditional open reduction and internal fixation(ORIF)in the treatment of Neer type Ⅱ,Ⅲ proximal humerus frac-tures.Methods The 80 patients with proximal humeral fractures were randomly divided into MIPPO group(treated with MIPPO)and ORIF group(treated with ORIF),according to different surgical methods,with 40 cases in each group.Surgery condition,fracture reduction angle,fracture healing time,pain VAS,range of shoulder joint motion,Con-stant-Murley score of shoulder joint function and complication incidence were compared between the two groups.Re-sults All patients were received postoperative follow-up of 6～12 months.The intraoperative fluoroscopy frequency in the MIPPO group was more than that in the ORIF group(P<0.05),the incision length,operation time,and the intra-operative blood loss,fracture healing time in the MIPPO group were all shorter(less)than those of ORIF group(P<0.05).The humeral neck-shaft angle,slope angle of humeral head in the ORIF group were better than MIPPO group(P<0.05).At 3,6,and 9 weeks postoperation,the VAS of MIPPO group was lower than the ORIF group(P<0.05).For the anteflexion,posterior extension,abduction,and external rotation of the shoulder joint activity,the data of postopertaive 9 weeks in the MIPPO group were larger than those of ORIF group(P<0.05).At 3 months postoper-ation,Constant-Murley score of shoulder joint in the MIPPO group was higher than that of ORIF group(P<0.05).The complication incidence of two groups had no statistical difference(P>0.05).Conclusions Compared to ORIF,MIPPO treatment for Neer typeⅡ,Ⅲproximal humeral fractures has advantages such as less trauma,less intraopera-tive blood loss,faster fracture healing,and better early recovery of shoulder joint function.However,there are also drawbacks such as excessive intraoperative fluoroscopy frequency and insufficient intraoperative exposure,which can affect the quality of fracture reduction.关键词
经皮微创接骨板固定技术/传统切开复位内固定术/肱骨近端骨折Key words
minimally invasive percutaneous plate osteosynthesis/open reduction and internal fixation/proximal hu-merus fractures分类
医药卫生引用本文复制引用
姜世斌,毛兆光,毛建华..两种手术方式治疗肱骨近端骨折的疗效比较[J].临床骨科杂志,2025,28(1):73-77,5.基金项目
浙江省江山市科技局科技计划项目(编号:JS2020D044) （编号:JS2020D044）
