gms | German Medical Science

Objectives: Compare the effect of B-ultrasonic body surface positioning of upper arm nerve combined with MIPPO technique and MIPPO technique alone in the treatment of middle and upper humeral shaft fractures.

Methods: A retrospective analysis of the data of 105 patients with middle and upper humeral shaft fractures admitted to Xi'an Honghui Hospital from August 2015 to May 2017. All patients were divided into two groups according to whether or not to use B-ultrasound surface to locate the upper arm nerves. There were 52 cases in the combined MIPPO technique group, 30 males and 22 females, aged 21–65 years old, with an average age of (45.7±7.8) years old, with only MIPPO technique There were 53 cases in the group, 32 males and 21 females, aged 24-61 years old, with an average of (46.2±10.3) years old. According to the operation time, intraoperative blood loss, fracture healing time and complication rate of the two groups of patients, and at the last follow-up, the Neer Shoulder Joint Function Score (MEPS) was used to evaluate the shoulder joint function to observe the curative effect.

Results: There was no statistically significant difference in the general data of patients in the combined group and the simple group before surgery (P>0.05), and they were comparable. The operation time of the combined group and the simple group were (62.8±8.6), (96.8±7.5) min, intraoperative blood loss was (107.4±5.6), (215.4±7.2) mL, and the complication rate was 7.7%. (4/52), 20.8% (11/53). The Neer shoulder function score results showed that the excellent and good rate of the combined group [94.2% (49/52)] was significantly higher than that of the simple group [81.1% (43/53)], and the difference was statistically significant (P<0.05).

Conclusion: For fractures of the upper and middle humerus, the experimental group was significantly better than the control group in terms of operation time, intraoperative blood loss and complication rate. For patients with middle and upper humeral fractures, MIPPO technology should be routinely performed upper arm nerve B-ultrasound positioning before surgery to reduce intraoperative bleeding and reduce complications.