闭合复位与切开复位解剖锁定板治疗胫骨远端骨折疗效比较

Closed reduction versus open reduction anatomical locking plate treatment of distal tibia fractures

目的比较闭合复位与切开复位解剖锁定板(LCP)固定治疗胫骨远端骨折的疗效。方法将92例胫骨远端骨折患者随机分为闭合复位(A组)和切开复位(B组)各46例,分别采用闭合复位经皮微创内或外侧解剖LCP固定治疗和切开复位LCP固定治疗,比较两组手术时间、术中出血量、住院时间、骨折愈合时间、下地时间。采用Tornetta标准对术后疗效进行评估。结果 A组在手术时间、术中出血量、住院时间、骨折愈合时间、下地时间及疗效满意度方面均优于B组,差异均有统计学意义(P<0.01,P<0.05)。结论闭合复位经皮微创治疗胫骨远端骨折创伤小,利于骨折愈合,可早期功能锻炼,疗效较切开复位解剖LCP固定治疗胫骨远端骨折好。

Objective To compare closed reduction and open reduction and anatomic locking plate （LCP） the curative effect of fixation for distal tibial fracture. Methods 92 patients with distal tibial fractures were randomly divided into closed reduction （group A） and open reduction （group B）, 46 cases with closed reduction and percutaneous minimally invasive inside or outside the anatomy of the LCP and LCP fixation （ORIF） fixed treatment, compared two groups of operation time, intraoperative blood loss, hospital stay, fracture healing time, down time. Tornetta standard was used to evaluate the postoperative efficacy. Results In group A in the operation time, intraoperative blood loss, hospitalization time, fracture healing time and walking time, functional satisfaction was better than that of group B, the difference had statistical significance （ P 〈 0. 01, P 〈 0.05 ）. Conclusions Closed reduction and percutaneous minimally invasive treatment of distal tibial fracture small trauma, conducive to fracture healing and early functional exercise, curative effect is relatively open reduction and the anatomy of the LCP fixation for distal tibial fracture.