A Comparative Study Of Minimally Invasive Percutaneous Plate Osteoynthesis And Open Reduction And Internal Fixation For The Treatment Of Humerus Surgical Neck Fractures

Objective: To investigate the clinical efficacy of percutaneous minimally invasive plate internal fixation(MIPPO)and traditional open reduction and internal fixation(ORIF)in the treatment of proximal humerus fractures.Methods: This study retrospectively analyzed the patients with surgical neck fractures of the humerus admitted to the First Affiliated Hospital of Fujian Medical University between January 2013 and October 2017.A total of 60 patients met the inclusion criteria.According to the different surgical methods adopted,60 patients were divided into two groups,the percutaneous minimally invasive plate fixation(MIPPO)group and the traditional open reduction and internal fixation(ORIF)group.A total of 28 patients in the MIPPO group had an average age of 56.8 years,including 8 males and 20 females.The left side was 15 and the right side was 13.According to Neer's classification,there were two partial fractures in 17 cases,three partial fractures in 10 cases,and four partial fractures.In the ORIF group,there were a total of 32 patients with an average age of 63.6 years,including 11 males and 21 females.The left side was 14 cases,the right side was 18 cases,the two parts had 22 fractures,the three parts had 6 fractures,and the four parts had 4 fractures.The observations included the number of days before surgery,the length of the surgical incision,the duration of the surgery,the amount of intraoperative blood loss,the total length of hospital stay,fracture healing time,last follow-up Neer shoulder function score,and last follow-up VAS pain score.The X-rays were regularly reviewed on the second,sixth,and twelfth week,and one year after surgery.The results were statistically analyzed using SPSS22.0 software.The clinical efficacy differences between the two groups were compared.Results: The general conditions of the two groups included gender,age,left and right sides,fracture classification,and injury-to-surgery time.There was no significant difference(P>0.05).All patients were followed up for 6-32 months with a mean follow-up of 16.5 months.According to the statistical analysis results,the mean incision length was 4.6cm in the MIPPO group,the average operation time was 90.3min,the average blood loss during the operation was 47.2ml,the average total hospitalization days was 12.6 days,the average postoperative Neer shoulder function score was 90.21,and the average VAS pain score was 1.21.The fracture healing time was 13.3 weeks.The ORIF group had an average incision length of 12.5cm and an average operative time of 111.8min.The average blood loss during the operation was 87.8ml.The average total length of hospital stay was 16.3 days.The average postoperative Neer shoulder function score was 83.96.The average VAS pain score 1.96,fracture healing time was 14.7 weeks,the difference was statistically significant(P<0.05).The rate of excellent and good shoulder function in the MIPPO group was 92.3%,and that of the ORIF group was 85.7%.All patients had normal fracture healing without delayed healing or fracture nonunion.Conclusion: For the surgical treatment of surgical neck fracture of humerus,percutaneous minimally invasive plate fixation and traditional open reduction and internal fixation have achieved satisfactory clinical results,but percutaneous minimally invasive plate fixation technology compared to traditional cutting For open reduction and internal fixation,advantages include small incision length,less intraoperative blood loss,shorter total hospital stay,less postoperative pain,good shoulder function recovery,and faster fracture healing time.