微创经皮钢板固定术治疗胫骨远端关节外骨折的临床效果观察

Clinical effect of minimally invasive percutaneous plate osteosynthesis in the treatment of distal tibial outside articular fractures

目的评价微创经皮钢板固定术治疗胫骨远端关节外骨折的临床效果,探讨其临床适用性。方法选择2011年1月至2013年5月于我院就诊的44例胫骨远端关节外骨折患者,简单随机分为观察组23例和对照组21例,对照组采用交锁髓内钉术进行治疗,观察组采用微创经皮钢板固定术治疗。观察两组患者的手术时间、术中出血量、住院时间、骨折愈合时间、术后并发症、踝关节功能评分和手术治疗效果。结果观察组患者术中出血量和平均住院时间与对照组比较差异均无统计学意义(P>0.05),但手术时间明显短于对照组,差异有统计学意义(P<0.05),两组患者的骨折愈合时间比较差异亦无统计学意义(P>0.05)。观察组患者术后并发症的发生率为8.7%,与对照组的14.3%比较差异无统计学意义(P>0.05)。随访患者术后12个月踝关节功能评分较术后1个月明显改善,差异均有统计学意义(P<0.05),而观察组和对照组术后1个月与术后12个月的踝关节功能比较差异均无统计学意义(P>0.05)。观察组患者12个月的治疗优良率为95.7%,对照组为95.2%,差异无统计学意义(P>0.05)。结论微创经皮钢板固定术治疗胫骨远端关节外骨折有效,并发症也比较少,可以很好地缓解踝关节功能,适合临床长期推广应用。

Objective To analyze the clinical effect of minimally invasive percutaneous plate osteosynthesis in the treatment of distal tibial outside articular fractures. Methods Forty-four patients of distal tibial articular frac-tures were selected from January 2011 to May 2014 in our hospital for treatment, which were simply randomly divid-ed into observation group of 23 cases and control group of 21 cases. The control group used intramedullary nail art for treatment, while the observation group applied minimally invasive percutaneous plate fixation for treatment. The sur-gery time, blood loss, hospital stay, fracture healing time, postoperative complications, ankle function score and surgi-cal therapy of two groups were observed. Results The ccomparison of blood loss and average length of stay of pa-tients showed no statistically significant difference between the observation group and control group （P〉0.05）, but the operative time of the observation group was significantly shorter than the control group （P〈0.05）. There was no statis-tically significant difference between the two groups in fracture healing time （P〉0.05）. The incidence of postoperative complications of the observation group was 8.7%, showing no statistically significant difference with 14.3% in the＆amp;nbsp;control group （P〉0.05）. During the follow-up, the postoperative ankle function scores 12 months after operation were improved significantly compared with those one month after operation （P〈0.05）, while the scores one month and 12 months after operation all showed no significant difference between the observation group and the control group （P〉0.05）. The excellent and good rate of treatment was 95.7%in the observation group and 95.2%in the control group, with no statistically significant difference （P〉0.05）. Conclusion Minimally invasive percutaneous plate fixation for the treatment of articular fractures of the distal tibial is effective and can well relieve ankle function, with fewer com-plications, which is suitable for long-term clinical application.