胫腓骨骨折带锁髓内钉与微创经皮钢板治疗的比较

Comparison of interlocking intramedullary nail and minimally invasive percutaneous plate osteosynthesis for tibia fractures

目的观察带锁髓内钉与微创经皮钢板治疗胫腓骨骨折的效果，比较两种方法的特点及临床适应证的选择。方法2000年6月～2004年6月采用带锁髓内钉与微创经皮钢板两种内固定方法闭合复位治疗胫腓骨骨折患者126例，比较胫腓骨骨折中使用带锁髓内钉组与微创经皮钢板组术中及术后的一般情况。结果两组患者在手术时间、出血量、切口大小、完全负重时间等方面差异有统计学意义（P〈0．05），但在骨折愈合时间、X线暴露次数、Johner—Wruhs评价、并发症的发生等方面差异并无统计学意义（P〉0．05）。结论两种方法都具有手术不剥离骨膜、创伤小等优点，带锁髓内钉适合胫骨干及胫骨多段骨折，微创经皮钢板对胫骨干或远端的骨折都适合。

Objective To observe the clinical results of interlocking intramedullary nail and minimally invasive percutaneous plate esteosynthesis （MIPPO）, and compare their properties and options of clinical indications. Methods One hundred and twenty - six cases of the tibia fracture underwent interlocking intramedullary nail and MIPPO from June 2000 to June 2004 were reviewed retrospectively. The general state of the patients was compared preoperatively and postoperatively. Results There were significant difference in the operating time, the bleeding, the length of incision and weight bearing time between two groups. While there were no significant difference in bone healing time, X - ray exposure frequency, Johner- Wruhs system and the complications between two groups. Condusion Both ways are considered much more effective in the treatment of tibia fracture. The interlocking intramedullary nail should be the first choice of the tibia shaft and mal- union of tibia fractures. MIPPO is a safe and effective technique in the treatment of tibia shaft and distal tibia metaphyscal fracture.