微创内固定技术与切开复位钢板内固定治疗胫骨远端骨折疗效比较

Efficacy comparison of minimally invasive internal fixation and open reduction and plate fixation for the treatment of distal tibial fracture

目的比较应用微创内固定技术(MIPPO)与传统切开复位钢板内固定治疗胫骨远端骨折的临床效果。方法按奇偶数分组方法对56例胫骨远端骨折患者分别采用MIPPO(MIPPO组,28例)和传统切开复位钢板内固定(传统组,28例)治疗,分别记录手术时间、术中出血量和住院时间;对比分析两组术后功能恢复及并发症情况。结果 56例均获随访,时间9～24个月。骨折愈合时间:MIPPO组为127 d±10.2 d,传统组为145 d±13.5 d,差异有统计学意义(P<0.01)。骨不连及延迟愈合发生率:MIPPO组为0,传统组为6%,差异有统计学意义(P<0.05)。踝关节Kofoed评分:MIPPO组为92.50分±1.50分,传统组为88.32分±1.32分,差异有统计学意义(P<0.01)。结论采用MIPPO技术治疗胫骨远端骨折创伤小,术中出血少,术后恢复快,可获得良好的踝关节功能。

Objective To compare the application of minimally invasive internal fixation technique(MIPPO) and open reduction and plate fixation for distal tibial fractures.Methods According to the odd and even number on 56 cases of distal tibial fracture were treated by MIPPO(MIPPO group,28 cases) and conventional open reduction and plate fixation(traditional group,28 cases) treatment.Operation time,intraoperative blood loss and hospitalization time were recorded;Comparative analysis were performed of two groups of postoperative functional recovery and complications.Results 56 cases were followed up for 9-24 months.The average fracture healing time was 127 d±10.2 d in MIPPO group,145 d±13.5 d in traditional group,the difference was statistically significant(P<0.01).Nonunion and delayed union of bone: incidence was 0 in MIPPO group,the traditional group was 6%,the difference was statistically significant(P<0.05).The ankle score: Kofoed MIPPO group was 92.50±1.50,traditional group was 88.32±1.32,the difference was statistically significant(P<0.01).Conclusions Using MIPPO technology for the treatment of distal tibial fracture is advantageous with little trauma,less bleeding,rapid postoperative recovery,which may obtain the good function of the ankle joint.