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Background humeral shaft fractures account for 1-3% of body fractures, humerus fractures, about 20% of the humeral shaft fracture, conservative treatment of humeral shaft fractures early to take a more functional brace, studies show that the majority of conservative treatment healed well and can be obtain a better function. However, some studies have shown that the conservative treatment of non-healing rate is higher than the surgery, shoulder and elbow activities can not be fully restored. The surgical treatment of patients with high-energy injury is more reliable. The a variety of ways of of surgical treatment, it is is the most commonly used to is to incision the the the nail of of of within the the fixed with the intramedullary in in the reduction and plate (intramedullary nail, IMN), the Both surgical approach have an pros and cons of. Plate fixation advantage for fixed firmly reduction under direct vision, can be exposed to the radial nerve and to avoid injury to the shoulder and elbow. The advantages of the intramedullary nail closed reduction, does not affect the blood supply and more in line with the fixed principles of biomechanics. The best surgical approach humeral shaft fractures remains controversial. The plate fixation rates are not high, but need more soft tissue stripping and other shortcomings: direct exposure of the fracture, and increase the amount of bleeding may damage the radial nerve destruction periosteal blood supply, and these may eventually lead to the failure of internal fixation and nonunion. Intramedullary nail treatment theoretically avoid these deficiencies, but some recent studies reported that the intramedullary nail may affect the function of the patient's shoulder or elbow. MIPO (Minimally invasive plate osteosynthesis, MIPO) technologies emerge to provide an alternative for humeral shaft fractures early cases reported a good effect, the MIPO technical soft tissue injury, compared with traditional surgery is a safe surgery, the healing rate is high and fewer complications. The MIPO technology only in the proximal and distal humerus each make a small incision closed reduction and to ensure that the blood of the fracture site far, better early functional exercises of the shoulder and elbow function. Objective To compare the treatment of humeral shaft fractures the MIPO technology with the IMN fixed technology clinical effect. Methods A retrospective analysis of hospital data orthopedic March 2007 to January 2009, 52 cases of humeral shaft fracture patients. MIPO group (n = 27) and IMN group (n = 25), according to the surgical approach is divided into the former closed reduction and minimally invasive front plate fixation, the latter using antegrade intramedullary nailing. Recording two groups of patients surgical time, blood loss, fracture healing time, complications, shoulder pain and elbow off function. Using the SPSS12.0 software on the statistical data processing. The results of the two groups of patients in terms of age, sex, and fracture classification constitutes no statistically significant difference. All in patients with After a an average of the at least 16 months of the follow-up. MIPO mean operative time was 104.6 minutes, average blood loss was 95.1ml, mean hospital stay was 6.9 days, with an average healing time was 12.9 weeks. No nonunion postoperative radial nerve paralysis cases. Shoulder Constant score averaged 90.6 points, elbow the Mayo score an average of 91.2 points. IMN mean operative time was 97.0 minutes, average blood loss was 88.7ml, the average hospital stay of 6.5 days, with an average healing time was 13.8 weeks. After four cases of nonunion and two cases of radial nerve palsy cases. IMN group 1 patients had varus deformity, but function well. Shoulder Constant score averaged 85.6 points, elbow Mayo score an average of 89.3 points. The Statistics analysis of display, the the fractures does not healing and shoulder joint Constant score to has a significantly sexual differences in (p lt; 0.05), the average healing time, intraoperative blood loss, the the postoperative an average of hospitalization time, radial nerve the occurrence of rate, Mayo score, and the average of operative time two groups of The difference was not statistically significant (p gt; 0.05). Conclusion better approach for humeral shaft fractures using the MIPO minimally invasive internal fixation technology, the main advantage lies not only in less trauma, less blood loss, faster recovery, faster bone healing, good shoulder and elbow function, but also has does not reveal the radial nerve and the advantages of reducing the risk of iatrogenic radial nerve injury occurred.
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