Điều trị gãy đầu trên xương cánh tay bằng kết hợp xương nẹp vít xâm lấn tối thiểu tại Bệnh viện huyện Củ Chi=Treatment of proximal humerus fracture with minimally invasive plate osteosynthesis at Cu Chi district Hospital

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Quang Tiến Đỗ, Mạnh Cường Nguyễn, Văn Nhật Phạm, Chánh Xuân Trần, Đình Lâm Trần

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Y học cộng đồng, 2023

Mô tả vật lý: tr.247-255

Bộ sưu tập: Metadata

ID: 477657

Thêm vào giỏ

Kết hợp xương nẹp vít xâm lấn tối thiểu (Minimally Invasive Plate Osteosynthesis: MIPO) gãy đầu trên xương cánh tay là xu hướng điều trị mới đã được áp dụng Việt Nam gần đây, tuy nhiên chưa có nghiên cứu nào đánh giá về hiệu quả của phương pháp này. Do đó, nghiên cứu “Điều trị gãy đầu trên xương cánh tay bằng kết hợp xương nẹp vít xâm lấn tối thiểu tại bệnh viện huyện Củ Chi” được tiến hành với mục tiêu đánh giá kết quả phục hồi góc chỏm thân xương cánh tay, phục hồi chức năng khớp vai và mô tả các biến chứng. Đối tượng và Phương pháp nghiên cứu: Nghiên cứu hồi cứu, mô tả loạt ca lâm sàng. Thu thập số liệu trên hồ sơ bệnh án bệnh nhân đã phẫu thuật MIPO gãy đầu trên xương cánh tay từ 12/2019 đến 02/2023 và thăm khám lâm sàng, cận lâm sàng trực tiếp trên bệnh nhân. Kết quả: 33 bệnh nhân (23 nữ, 10 nam), 64,67 tuổi ± 14.05 (32 – 88 tuổi), phân loại AO: A2 (12 bệnh nhân), A3 (4 bệnh nhân), B1 (16 bệnh nhân), C1 (1 bệnh nhân), thời gian phục hồi chức năng (PHCN) 26,06 tháng (6 – 44 tháng). Góc chỏm thân xương cánh tay là 132,65° ± 5,07° (117,83° – 140,84 °), kết quả theo Paavolainen: 32/33 tốt, 1/33 trung bình. Điểm PHCN theo Constant Murley là 69,58 ±10,05, kết quả PHCN theo Boehm: 27/33 rất tốt, 3/33 tốt, 2/33 khá, 1/33 kém. Có 4/33 biến chứng gồm: 1 nhiễm trùng nông, 2 tổn thương thần kinh nách tạm thời, 1 cứng khớp vai. Kết luận: MIPO gãy đầu trên xương cánh tay cho kết quả phục hồi góc chỏm thân xương cánh tay, phục hồi chức năng tốt, ít xảy ra các biến chứng.Minimally Invasive Plate Osteosynthesis (MIPO) proximal humerus fracture is a new treatment trend that has been applied in Vietnam recently, however, there is no research to evaluate evaluation of the effectiveness of this method. Therefore, the study “Treatment of proximal humerus fracture with minimally invasive plate osteosynthesis at Cu Chi district hospital” was conducted with the aim of evaluating the results of restoration of head – humerus shaft angle, shoulder rehabilitation and description of complications. Methods: Retrospective, clinical case series description. Collecting data on the medical records of patients undergoing MIPO surgery for humeral head fracture from December 2019 to February 2023 and performed clinical and subclinical examinations directly on the patient. Results: 33 patients (23 women, 10 men), age: 64.67 ± 14.05 (32 – 88 years), AO classification: A2 (12 patients), A3 (4 patients), B1 (16 patients), C1 (01 patient), rehabilitation period 26.06 months (6 - 44 months). Head – humerus shaft angle is 132.65° ± 5.07° (117.83° – 140.84°), results according to Paavolainen: 32/33 good, 1/33 moderate. The rehabilitation score according to Constant Murley is 69.58 ±10.05, the result of rehabilitation according to Boehm: 27/33 (81,8%) excellent, 3/33 (9,1%) good, 2/33 (6,1%) satisfactory, 1/33 (3%) poor. There were 4/33 12,1%) complications including: 1 superficial infection, 2 temporary axillary nerve damage, 1 shoulder stiffness. Conclusion: MIPO proximal humerus fracture resulted in restoration of the humerus stem angle, good function recovery, and few complications.

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