Mippo技术和切开复位锁定钢板内固定治疗胫骨中远段骨折的实践管理效果比较

Mippo Technology and Locking plate Internal Fixation(orif) to Cosco fortibial Fracture Effect is the Practice of Management

目的比较MIPPO（minimally invasive percutaneous plate osteosynthesis,微侵入经皮钢板植入技术和切开复位锁定钢板治疗胫骨中远段骨折的管理效果。方法选取2008年3月—2015年10月胫骨中远段骨折139例,采用MIPPO技术治疗胫骨骨折71例,采取传统切开复位内固定手术68例,术后随访观察两组手术时间、术中出血量、切口长度、住院时间、骨折愈合时间、关节功能进行分析。结果 MIPPO组随访时间6～23（15±0.2）个月,切开组随访时间6～36（18±0.5）个月,MIPPO组在术中出血量、切口长度、住院时间及骨折愈合时间均优于切开组。术后关节功能恢复按照Johner-Wruhs功能评价方法,分为优、良、中、差,MIPPO组/切开组：优60/52例、良9/8例、中2/5例、差0/3例,优良率为97.2%/88.2%,MIPPO组优于切开组。结论 MIPPO技术结合锁定加压钢板内固定治疗胫骨中远段骨折具有创伤小、并发症少、骨愈合率高、实践效果满意等优点,值得临床广泛应用。

Objective MIPPO（minimally invasive percutaneous plate osteosynthesis, micro invasive percutaneous plate osteosynthesis and clinical effect of open reduction and locking plate for treatment of distal tibial shaft fractures. Methods From March 2008-2015 year in October 139 cases of distal tibial shaft fracture, 71 cases of fracture by MIPPO technique in the treatment of tibia, take the traditional open reduction and internal fixation in 68 cases, postoperative follow-up observation of two groups of operation time, bleeding volume, hospitalization time, incision length, fracture healing time, joint function analysis. Results MIPPO patients were followed up from 6 to 23（15±0.2） months, incision group were followed up for 6 to 36（18±0.5）months. In MIPPO group, intraoperative blood loss, length of incision, hospitalization time and healing time were better than open group. According to the Johner- wruhs evaluation method, points as excellent, good, moderate and poor, MIPPO group / open group： excellent in 60 / 52 cases, good in 9 / 8 cases, moderat in 2 / 5 cases, poor in 0 / 3cases, the excellent and good rate is 97.2% / 88. 2%, MIPPO group is better than the open group. Conclusion MIPPO technology combined with locking compression plate fixation in the treatment of tibial fractures of distal segment fractures has advantages of less trauma, less complications, bone healing rate is high and satisfactory clinical effects etc., and conventional open reduction and internal fixation for the treatment of comparison, highlighting the advantages, it is worth clinical application.