微创经皮钢板内固定术结合锁定加压钢板治疗Pilon骨折的疗效观察

目的观察微创经皮钢板内固定术（MIPPO）结合锁定加压钢板（LCP）治疗Pilon骨折的临床疗效。方法57例Pilon骨折患者根据手术方式不同分为两组，0RIF组（n=27例）和MIPPO＋LCP组（n=30例）。比较两组患者手术时间、血肿吸收时间、术后住院时间及骨折恢复时间，所有患者均随访1年，比较两组骨折不愈合、延迟愈合、关节僵硬、固定失败、关节疼痛、切口感染等并发症发生情况。结果MIPPO＋LCP组优良率（93．3％）明显高于ORIF组（77．8％）（P〈0．05）；MIPPO＋LCP组手术时间、血肿吸收时间、术后住院时间及骨折恢复时间均明显少于ORIF组（P〈0．05）；MIPPO＋LCP组骨折不愈合、延迟愈合、关节僵硬、固定失败、关节疼痛、切口感染等并发症发生率（16．7％）均明显低于ORjF组（40．7％）（P〈0．05）。结论MIPPO结合LCP治疗Pilon骨折疗效显著，可缩短住院时间，促进骨折尽快恢复，明显降低术后不良反应发生率。

Objective. To observe the clinical curative effect of minimally invasive percutaneous plate osteosynthesis （ MIPPO ） combined with locked compression plate （ LCP ） in the treatment of Pilon fractures. Methods 57 patients with Pilon fractures were divided into 2 groups according to different operation method, ORIF group （ n=27cases ） and MIPPO＋LCP group （ n=30 cases ） . The operation time, hematoma absorption time, postoperative hospital stay and fracture healing time of two groups were compared, all patients were followed up for 1 year, and the complications such as fracture healing, delayed healing, stiff joints, fixed failure, joint pain, infection of incision of two groups were compared. Results the excellent and good rate of MIPPO＋LCP group （ 93.3% ） was significantly higher than that of ORIF group （ 77.8% ） （ P〈0.05 ） . The operation time, fracture hematoma absorption time, postoperative hospitalization time and recovery time of MIPPO＋LCP group were significantly less than that of ORIF group （P-0.05） . The incidence of complications such as fracture healing, delayed healing, stiff joints, fixed failure, joint pain, infection of incision of MIPPO＋LCP group （ 16.7% ） were significantly lower than that of ORIF group （ 40.7% ） （ P〈0.05 ） . Conclusion The treatment of MIPPO combined with LCP for Pilon fractures has an obvious therapeutic effect, which can shorten the length of hospital stay, promote fracture restore as soon as possible, significantly reduce the incidence of postoperative adverse reactions.