应用微创经皮钢板固定技术结合解剖钢板治疗胫骨远端粉碎性骨折

Minimally Invasive Percutaneous Plate Technology Combined with Anatomic Plate in Treatment of Comminuted Distal Tibial

目的探讨微创经皮钢板固定技术(MIPPO)结合解剖钢板治疗胫骨远端粉碎性骨折的临床疗效。方法整群选取该院2011年10月—2014年10月间172例胫骨远端粉碎性骨折患者分为对照组和观察组。对照组仅使用外固定架至骨折愈合后拆除,未行内固定术;观察组应用MIPPO结合解剖钢板治疗,比较两组患者的手术时间、术中出血量和骨折愈合时间。结果观察组的手术时间长于对照组,术中出血量多于对照组,但骨折愈合时间短于对照组,比较差异有统计学意义(P<0.05)。观察组Joher-Wruhs法评分优良率为97.67%;对照组评分优良率为83.72%。观察组高于对照组,但差异无统计学意义(P>0.05)。结论应用微创经皮钢板固定技术(MIPPO)结合解剖钢板治疗胫骨远端粉碎性骨折手术损伤较低,可促使患者早日康复,具有临床推广价值。

Objective To investigate the clinical efficacy of minimally invasive percutaneous plate fixation（MIPPO） combined with anatomical plate in the treatment of comminuted fracture of distal tibial. Methods 172 patients with comminuted fracture of distal tibial in our hospital between October 2011 and October 2014 were divided into control group and observation group. External fixator was singly used in the control group until fracture healing while MIPPO combined with anatomical plate was performed in the observation group. The operation duration, intraoperative blood loss, fracture healing time was compared between the two groups.Results The operation duration was longer, and the intraoperative blood loss more, but the fracture healing time shorter in the observation group than in the control group, and the differences were statistically significant（P〈0.05）. According to Johner-Wruhs, the excellent and good rate of the two groups was 97.67% and 83.72%, and the observation group was superior to the control group,but the difference was not statistically significant（P〉0.05）. Conclusion MIPPO combined with anatomic plate is worthy of promotion in the treatment of comminuted fracture of distal tibial due to its light trauma and quick recovery.