Comparison Of MIPO Technique Combined With Locking Compression Plate And Antegrade Interlocking Intramedullary Nail Fixation In The Treatment Of Middle Humeral Shaft Fracture In Adults

Preface:Humeral shaft fractures account for approximately 3% of all types of fractures.In the 1970 s,functional support was common in the treatment of humeral shaft fractures and was the standard treatment for such fractures.Fractures in some cases,however,is more suitable for surgery,including multiple trauma,open fracture,combined vascular injury,ipsilateral joint damage,floating elbow,and the failure of conservative treatment cases.Surgical treatment mainly includes external fixator,open reduction internal fixation(ORIF),minimally invasive transdermal plate internal fixation(MIPO),as well as the alignment and retrograde intramedullary needle fixation.Each fixed method has its advantages and disadvantages,and the rate of fracture healing varies.Open reduction plate internal fixation used to be considered as the "gold standard" for the treatment of humeral shaft fracture.This method can be used for reduction and reduction.Objective:To compare the clinical effect of MIPO technology combined with locking compression plate and antegrade interlocking intramedullary nail fixation in the treatment of adult humeral shaft fracture.Methods:Select the second hospital of shanxi medical university orthopaedic since January 2005 to March 2015 a total of 50 cases of humeral fractures in middle of adult patients,including: using MIPO technology combined therapy with LCP for 29 cases,adopt anterograde/locking intramedullary nail treatment for 21 cases.Retrospective analysis of the patient's inpatient data,including surgical time,intraoperative blood loss,fracture healing time,shoulder and elbow function,etc.SPSS22.0 software was used for statistical analysis to reach the conclusion.Results:There was no statistical difference between the two groups in age,gender and fracture classification.All patients were followed up for at least 18 months.The average operation time of the MIPO group was 99.1min,and the average intraoperative bleeding was 95.2ml,the average length of hospitalization was 6.8 days,and the average fracture healing time was 12.5 weeks.There were two cases of radial nerve paralysis after surgery without fracture.UCLA scored an average of 32.6 points,with an average of 92.2.The average operation time of the IMN group was 100.3min,the average amount of blood loss was 80.5ml,the average length of hospitalization was 6.4 days,and the average fracture healing time was 11.8 weeks.There were 3 cases of nonunion after operation and 1 case of radial nerve paralysis.The average UCLA score was 30.0,elbow.Conclusion:For adult middle to shaft of humerus fractures treated using MIPO technology combined with locking compression plate is a relatively feasible solution,is minimally invasive,intraoperative blood loss,postoperative recovery fast,and shoulder joint function better than the intramedullary nail treatment,elbow function and intramedullary nailing group,no difference.At the same time,the surgical method does not expose the radial nerve,and compared with the traditional surgical method,it can reduce the risk of iatrogenic radial nerve injury.