背景:肱骨干骨折是上肢的常见损伤,主要的手术治疗方式是锁定加压钢板(LCP)技术。前内侧微创接骨板(MIPO)技术的出现使其在临床实践中逐步实施。然而,MIPO的疗效和长期结果需要进一步调查。本研究的目的是比较LCP和MIPO在肱骨干骨折治疗中的疗效。
方法:本研究对2016年6月至2019年12月诊断为肱骨干骨折的患者进行了回顾性分析。根据手术方式的不同将患者分为MIPO组和LCP组。该研究分析了住院时间,辐射暴露,手术时间,和术后手臂的残疾,肩和手(DASH)得分使用统计方法。
结果:共有53名符合纳入标准的患者被纳入研究。与LCP组相比,MIPO组的住院时间显着减少(住院时间:5.39±2.23天vs12.00±7.19天,P<0.001)。所有患者均在手术后形成骨痂。然而,MIPO组的辐射暴露量明显高于LCP组(45.96±19.49vs5.33±2.20,P<0.001)。此外,从入院到手术的时间没有统计学上的显着差异,手术时间,两组之间的愈合时间(从入院到手术时间:P=0.593;手术时间:P=0.407;愈合时间:P=0.664)。术后随访期间,与LCP组相比,MIPO组的6周和3个月DASH得分显着降低(6周:34.17±12.16vs45.65±22.94,P=0.028;3个月:17.43±11.70vs30.12±9.80,P<0.001)。然而,两组6个月和12个月的DASH评分差异无统计学意义(6个月:P=0.787;12个月:P=0.058)。
结论:与LCP技术相比,MIPO技术在治疗肱骨干骨折方面提供了更好的肩肘短期功能恢复,同时确保等效的手术愈合。
BACKGROUND: Humeral shaft fractures are a common injury of the upper limb, with the primary surgical treatment modality being the locking compression plate (LCP) technique. The advent of Anterior medial minimally invasive plate osteosynthesis (MIPO) technology has led to its gradual implementation in clinical practice. However, the efficacy and long-term outcomes of MIPO require further investigation. The objective of this
study is to compare the therapeutic effects of LCP and MIPO in the management of humeral shaft fractures.
METHODS: The present
study conducted a retrospective review of patients diagnosed with humeral shaft fractures between June 2016 and December 2019. The patients were divided into MIPO and LCP groups based on the different surgical methods. The
study analyzed the length of hospital stay, radiation exposure, operative time, and postoperative Disabilities of the Arm, Shoulder and Hand (DASH) scores using statistical methods.
RESULTS: A total of 53 patients who met the inclusion criteria were included in the
study. The MIPO group demonstrated a statistically significant reduction in length of hospital stay compared to the LCP group (length of hospital stay: 5.39 ± 2.23 days vs 12.00 ± 7.19 days, P < 0.001). All patients achieved callus formation after surgery. However, the MIPO group had significantly more radiation exposures than the LCP group (45.96 ± 19.49 vs 5.33 ± 2.20, P < 0.001). Additionally, there was no statistically significant difference observed in the time from admission to surgery, operative time,and healing time between the two groups (the time from admission to surgery: P = 0.593; operative time: P = 0.407; Healing time: P = 0.664). During the postoperative follow-up, the MIPO group exhibited significantly lower 6-week and 3-month DASH scores compared to the LCP group (6-week: 34.17 ± 12.16 vs 45.65 ± 22.94, P = 0.028; 3-month: 17.43 ± 11.70 vs 30.12 ± 9.80, P < 0.001). However, there was no statistically significant difference in the 6-month and 12-month DASH scores between the two groups (6-month: P = 0.787; 12-month: P = 0.058).
CONCLUSIONS: The MIPO technique provides better short-term functional recovery of the shoulder and elbow compared to the LCP technique in the treatment of humeral shaft fractures, while ensuring equivalent surgical healing.