微创经皮钢板和带锁髓内钉治疗胫骨骨折的比较分析

The clinical study of treating tibia fracture by minimally invasive percutaneous plate osteosynthesis

目的 探讨微创经皮钢板在治疗胫腓骨骨折的临床疗效。方法 对57例胫骨骨折患者随机分为微创经皮钢板组与带锁髓内钉组两种内固定方法治疗，对比分析其术中及术后的一般情况。全部病例获得随访．时间12—30个月，平均16个月。结果两组患者在切口大小、手术时间、出血量、完全负重时间等方面差异显著（P〈0．05），但是在骨折愈合时间、X线暴露时间、Johner-Wruh评价、并发症的发生等方面差异并无显著性。结论 两者都具有手术不剥离骨膜、能减少对骨折处血运的干扰、创伤小等优点，带锁髓内钉适合胫骨骨干及胫骨多段骨折，微创经皮钢板对胫骨骨干或干骺端的骨折都适合。

Objective To investigate the clinical curative effect of treating tibia fracture by minimally invasire percutaneous plate osteosynthesis （MIPPO）. Methods Fifty-seven cases of tibia fracture which were divided in to the MIPPO group and the interlocking intramedullary nail group randomly were treated with two kinds of internal fixations. The data of Fifty-seven patients were analyzed retrospectively, and patients＇ general state during and after the operation was compared. All the patients were followed up for 12-30 months after operation （average 16 months）. Five factors including surgery time, intraoperation bleeding, inhospital time, healing time and complications were studied statistically to analyse the two kinds of internal fracture fixations. Results Treatment of tibia fracture with MIPPO was as good as interlocking intramedullary nail. There was no significant difference between two groups in surgery time, intraoperation bleeding, inhospital time, healing time and complications. Conclusion The two therapies both can reduce disturbing vascularization of bone fragment, accelerate bone healing and reduce complications. The interlocking intramedullary nail should be the first choice for tibia shaft and malunion of tibia fracture as well as MIPPO for tibia shaft and distal tibia metaphyseal fractures.