微创经皮锁定加压钢板内固定治疗四肢粉碎骨折的临床研究

Clinical study of minimally invasive percutaneous lock pressure plate fixation in the treatment of the limbs fracture crushed

目的观察微创经皮锁定加压钢板内固定治疗四肢粉碎性骨折的疗效,并与传统切开复位内固定方法对比,探讨两种手术方法的疗效差异。方法将112例符合手术适应证的四肢粉碎性骨折患者随机分为微创手术组和传统手术组,分别采取对应手术方法,比较两组患者的的手术时间、住院时间、术中出血量、术后骨移植例数、术后并发症发生率及骨愈合时间。结果微创手术组的手术时间[(91.7±9.4)min]及住院时间[(14.7±5.5)d]短于传统手术组[(114.5±13.9)min、(19.5±5.9)d];微创手术组的术中出血量[(88.5±18.6)mL]较传统手术组[(270.7±52.6)mL]少,并且其术后骨移植例数(1例)少于传统手术组(7例),微创手术组的术后并发症发生率(5.35%)低于传统手术组(16.07%);骨愈合时间微创手术组[(14.3±4.2)d]短于传统手术组[(23.5±5.1)d],以上数据差异均有统计学意义(均P<0.05)。结论微创经皮锁定加压钢板内固定治疗四肢粉碎性骨折的总体疗效优于传统切开复位内固定术,对于有适应证的患者推荐采用该手术方法。

Objective To observe the efficacy of minimally invasive percutaneous locking plate fixation in the treatment of limbs comminuted fracture,and compare with traditional internal fixation,discuss the differences of two surgical methods.Methods 112 limbs comminuted fracture patients with operation indications were randomly divided into the minimally invasive operation group and traditional operation group.Corresponding surgical method were taken,the operation time,length of hospital stay,operative bleeding and postoperative bone graft and postoperative complications and bone healing time of the two groups were compared.Results Minimally invasive srugery group＇s operation time [（91.7±9.4） min] and length of hospital stay [（14.7±5.5） d] were shorter than traditional operation group[（114.5±13.9） min,（19.5±5.9） d].Operative bleeding of minimally invasive surgery group [（88.5±18.6） mL] were less than traditional operation group[（270.7±52.6） mL],and the postoperative bone grafts number（1 case） is less than the traditional group（7 cases）,the minimally invasive group＇s incidence rate of postoperative complications（5.35%） was also lower than traditional group（16.07%）.Bone healing time of minimally invasive operation group [（14.3±4.2） d] was shoter than traditional group[（23.5±5.1） d].The differences of the data above were all statistically significant（all P 0.05）.Conclusion The effect of minimally invasive percutaneous lock pressure plate fixation in the treatment of limbs comminuted fracture is superior than the traditional open group,the lumbosacral tuberculosis patients with indications can be recommend the minimally invasive surgical treatment.