两种内固定方法在治疗胫骨开放性骨折中的应用

Two internal fixations for severe open tibial fracture

目的观察应用MIPPO技术下LCP钢板与带锁髓内钉内固定治疗胫骨开放性骨折的临床疗效。方法手术治疗46例胫骨开放性骨折患者,根据临床骨折具体情况分为2组:A组25例,采用MIPPO技术下LCP钢板内固定;B组21例,采用带锁髓内钉内固定术。术后定期随访,膝踝关节功能恢复情况按Johner-Wruhs评分标准进行功能评价。结果 46例均获随访,时间10～36(25±1)个月。A组优19例,良4例,可2例;B组优12例,良7例,可1例,差1例;A、B两组优良率分别为92.0%和90.4%。结论在治疗开放性胫骨骨折时,如能彻底清创,正确选择适应证,MIPPO技术下LCP钢板及带锁髓内钉内固定均是治疗开放性胫骨骨折的有效方法。

Objective To investigate minimally invasive percutaneous plate osteosynthesis（MIPPO）with locking compressive plate（LCP）and interlocking intramedullary nail internal fixation in the open tibial fracture.Methods 46 adult patients were enrolled in this study（25 patients,group A,were treated by LCP plate internal fixation and 21 patients,group B,were treated by interlocking intramedullary nail）.Following up the was carried out regularly.Johner-Wruh criteria was used to analyze the function of ankle-knee joint.Results 46 cases were followed up for 10～36（25±1）months,the therapeutic effect were evaluated as excellent in 19,good in 4,fair in 2 in group A and 12,7,1,1 respectively in group B.The therapeutic effect was 92.0% and 90.4%.Conclusions Two internal fixations can both result in better function recovery with drastically debridement and proper indications in the open tibial fracture.