微创经皮钢板与带锁髓内钉治疗胫骨骨折的疗效比较

A comparison of results between minimally invasive percutaneous plate osteosynthesis and interlocking intramedullary nall for treatment of tibia fracture

目的比较微创经皮钢板与带锁髓内钉治疗胫骨骨折的临床疗效。方法采用带锁髓内钉与微刨经皮钢板两种内固定方法分别治疗胫骨骨折患者35例和50例，比较两种治疗方法的手术时间、手术出血量、平均住院日、骨折愈合时间和并发症等；术后随访12—30个月，采用Johner-Wruh评价方法，比较两种治疗方法的肢体功能恢复情况。结果微创经皮钢板内固定术出血量（60．3±6．6）ml、平均手术时间（96．5±5．0）min、骨折愈合时间（16．2±7．4）周与带锁髓内钉内固定术[（110．0±8．5）ml、（170．6±6．2）min、（19．5±5．6）周]比校，差异均有统计学意义（均P〈0．05），而两组的平均住院时间、Johner-Wruh评价、并发症发生率等比较，差异均无统计学意义（均P〉0．05）。结论两种内固定方法治疗胫骨骨折都具有较高治愈率和远期治疗效果，微创经皮钢板内固定术具有创伤小、恢复快等特点，是治疗胫骨骨折的理想方法。

Objective To compare the clinical results between minimally invasive pereutaneous plate osteosynthesis（MIPPO） and interlocking intramedullary nail（IIN） for treatment of tibia fracture. Methods 50 cases with tibia fracture were treated with MIPPO technique and 35 cases were treated with IIN. Five factors including surgery time,interoperafion bleeding,in hospital time, healing time and complications were studied statistically to analyze the two kinds of internal fracture fixations. All the patients were followed up for 12 - 30 months after operation（ average 16 months）. Compare the condition of limb functional recover between the two kinds of internal fracture fixations according to Johner-Wruhs standard. Results The operating time [ （ 96.5 ±5.0） min ], the bleeding [ （ 60. 3 ±6.6 ） ml ] and the bone healing time[ （ 16.2 ± 7.4） week] in MIPPO group were significantly lower than in the IIN group（ allP 〈 0. 05）. The operating time was（ 170. 6 ±6. 2）ml,the bleeding was（ 110. 0 ± 8.5） rain and the bone healing time was （ 19.5± 5. 6 ）week in the IIN group. While there were no significant difference in hospital time ,Johner-Wrnhs system and the complications between IIN and MIPPO group（ allP 〉 0. 05 ）. Conclusion It has high cure rate and long-term curative effect that the two kinds of internal fracture fixations for treatment of tibia fracture. The technique of MIPPO has the advantages of small trauma and quickly recovery characteristics. It was a ideal therapy in treatment of tibia fracture.