| Objective To analyze the therapeutic effect and complications of MIPPO surgery during the treatment of patients with Neer type Ⅴ three-part proximal humeral fracture.Methods A total number of 60 patients who underwent surgical treatment due to proximal humeral fractures in the Fifth Hospital of Harbin City from June 2021 to June 2023 were enrolled in this retrospective analysis. These patients were divided into two groups according to different surgical incisions. There were 30 cases in minimally invasive anterolateral incision MIPPO group and 30 cases in the traditional deltoid pectoralis major gap approach group. The operative time, amount of bleeding during operation, in-patient duration, VAS score, post-operative 3, 6, 12 months Constant-Murley shoulder joint function, and incidence of complications were compared between the two groups.Results The 60 patients were followed up for 12-16 months, with an average of (13.40±1.38) months. The operative time [(86.17±11.04) min] and the amount of bleeding during operation [(161.33±31.15) mL] of the minimally invasive group were significantly lower than those of the traditional approach group [(103.17±11.48) min, [(215.17±42.11) mL], with statistical significance (P<0.05). However, there was no statistically significant difference in in-patient duration between the two groups (P>0.05). The VAS scores of the minimally invasive group were significantly lower than those of the traditional approach group at post-operative 3 and 7 d, and the difference was statistically significant (P<0.05). In the absence of postoperative analgesia, the pain degree of the surgical area of the minimally invasive group was significantly lower than that of the traditional approach group. The shoulder joint function of the minimally invasive group was significantly better than that of the traditional approach group at post-operative 3 and 6 months (P<0.05). There was no statistically significant difference in Constant-Murley shoulder joint function scores at 12 months after surgery (P>0.05). The incidence of complications in the minimally invasive group was higher than that of the traditional approach group, and the difference between the two groups was statistically significant (P<0.05).Conclusion The MIPPO technique for the treatment of Neer type V tripartite proximal humerus fractures has certain advantages in terms of operative time, intraoperative bleeding, surgical site pain, and early functional activity compared with the traditional approach. However, the incidence of complications is higher than that of the deltoid pectoralis major approach, and there is no significant difference in the length of hospital stay and recovery of shoulder function. The surgical approach should be chosen according to clinical practice. |
