3种手术方法治疗胫骨干骺端骨折的疗效分析

Analysis of curative effect of three operation methods in treatment of tibial metaphysis fractures

目的评价采用微创经皮钢板固定技术(MIPPO)结合锁定加压钢板(LCP)、超关节外固定架、切开复位普通钢板固定3种手术方法治疗胫骨干骺端骨折的疗效。方法采用MIPPO技术结合LCP内固定的61例为A组,采用超关节外固定架外固定的23例为B组,切开复位普通钢板内固定的25例为C组,比较3组手术时间、术中出血量、骨折愈合时间、关节功能及术后并发症情况。结果 A组在骨折愈合时间、并发症发生率及踝关节功能方面优于B组,差异有统计学意义(P<0.05);A组在手术时间、术中出血量、骨折愈合时间、并发症发生率及踝关节功能方面优于C组,差异有统计学意义(P<0.05)。结论 LCP结合MIPPO技术内固定比超关节外固定架固定及切开复位普通钢板内固定治疗胫骨干骺端骨折更具有优势,是治疗胫骨干骺端骨折的理想方法。

Objective To evaluate the curative effect of LCP combined with minimally invasive percutaneous plate fixation （MIPPO） technology internal fixation, over-articular external fixation, open reduction and internal fixation with ordinary plate in the treatment of proximal tibial metaphysis fractures. Methods LCP combined with MIPPO technology internal fixation was used in 61 cases as A group, over articular external fixator in 23 cases as B group, open reduction and internal Fzxation of the ordinary in 25 cases as C group. The operation time, amount of bleeding, fracture healing time, ankle joint function, the incidence of complications after operative were compared among the three groups. Results There were significant differences in fracture healing time, the incidence of complications and ankle joint function between group A and B （P 〈0.05）. There were significant differences in operation time, amount of bleeding, fracture healing time, joint function, the incidence of complications between group A and C（P 〈0.05）. Conclusion LCP combined with the technology of MIPPO internal fixation is better than the over-articular external fixation and open reduction and ordinary plate fixation in the treatment of metaphyseal fracture of tibia with more advantages. It is the ideal method for treatment of tibial metaphyseal fractures.