上腕骨近位端骨折に対する polyaxial locking plate を用いた MIPO

抄録

The purpose of this study is to evaluate the short term results of minimally invasive plate osteosynthesis (MIPO) for displaced proximal humeral fractures using a polyaxial locking plate. We examined 7 patients who underwent MIPO for proximal humeral fractures using the non-contact bridging (NCB) plate system with a minimum follow up of 6 months after surgery. These were 2 males and 5 females and the average age was 56.9 years old (37-76 years old). According to AO classification, A2 and A3 was one each, B1 was three and C1 was two. Plate osteosynthesis was done using two small (3cm each) skin incisions. Postoperatively, the arm was immobilized with a sling for 2 weeks and passive motion exercise was initiated the day after surgery. The average operating time was 116 minutes. Bone union was obtained in all patients, but one patient had postoperative displacement of a greater tuberosity fragment which required the revision surgery. The other complications including screw loosening, humeral head perforation of the screws and axilliary nerve palsy were not observed. The average JOA score at 6 months after surgery was 89.6 points (80-94). Although a number of improvements such as the profile of the implant and operative techniques are desired, MIPO with use of a polyaxial locking plate is thought to be a promising procedure for surgical treatment of displaced proximal humeral fractures.