微创经皮锁定钢板与髓内钉治疗胫骨下段骨折的疗效观察

The efficacy observation of minimally invasive percutaneous plate and intramedullary nail for distal tibial fracture

目的观察比较微创经皮锁定钢板（Percutaneous locked plating,PLP）与髓内钉（Intramedullary nailing,IMN）治疗胫骨下段骨折的临床效果。方法回顾分析2010年1月～2012年12月我院骨科120例胫骨下段骨折患者,其中60例患者采用PLP治疗,60例患者采用IMN治疗,随访12～18个月,平均14个月,比较两组患者的疗效、术中骨折端切开率、开始负重时间,骨折愈合时间、术后并发症。结果 IMN组优良率为93.33%,PLP组优良率为75.00%,IMN组治疗效果明显优于PLP组（P〈 0.05）。IMN组与PLP组相比较,术中骨折端切开率低、骨折愈合时间短、下地负重时间早（P〈 0.05）,两组间具有统计学意义。结论 PLP与IMN都是有效治疗胫骨下段骨折有效的办法,但IMN疗效更为明显,术中骨折端切开率较低,骨折愈合时间短,开始负重时间较早。

Objective To compare the efficacy of minimally invasive percutaneous plate osteosynthesis（PLP） and IMN treatment of distal tibial fracture. Methods 120 cases of orthopedic patients with tibial fractures in our hospital from January2010 to December 2012 were randomly divided into two groups, of which 60 patients were treated with PLP treatment,60 cases of patients with IMN treatment up for 12 to 18 months, with an average of 14 months. The therapeutic effect,including intraoperative fracture rate cut, fracture healing time, weight bearing, postoperative complications, of the two groups, were compared. Results Excellent rate of intramedullary nail treatment group was 93.33%, and of PLP treatment group was 75.00%. The efficacy of intramedullary nail group is better than locking compression plate group（ P〈 0.05）.Compared to locking compression plate treatment, the intramedullary nail treatment has the advantage of low rate of incision, short healing time, early weight-bearing（P〈 0.05）. Conclusion The preoperative invasive percutaneous plate fixation（MIPPO） and IMN are effective ways to treat the distal tibial fracture, but the IMN effect is more obvious, intraoperative fracture cut low open rate, short healing time, weight-bearing ambulation time earlier.