MIPO在胫骨Pilon骨折治疗中的作用研究

The role of MIPO in the treatment of tibial Pilon fractures

目的探讨微创接骨板接骨术(minimally invasive plate osteosynthesis,MIPO)在胫骨Pilon骨折治疗中的作用。方法选取2013年1月至2015年12月于本院治疗的胫骨Pilon骨折患者60例为研究对象,将其随机分为观察组和对照组,每组各30例。对照组患者采用有限切开复位置入锁定加压钢板(locking compression plate,LCP)治疗,观察组患者在对照组治疗基础上结合MIPO治疗,观察并比较两组患者手术相关指标、治疗效果以及术后1、3、6个月踝关节功能恢复情况。结果观察组患者手术时间[(121.52±20.42)分钟]明显长于对照组[(95.07±18.16)分钟](P<0.05);观察组患者骨折愈合时间[(65.42±12.10)天]明显短于对照组[(80.11±10.46)天](P<0.05);两组患者术中出血量和住院天数比较均无显著差异(P>0.05);观察组优良率(93.33%)明显高于对照组(70.00%)(P<0.05)。观察组患者术后1、3、6个月踝关节功能评分[(72.21±7.69)分、(81.43±9.24)分、(90.08±9.68)分]均明显高于同期对照组[(63.48±8.69)分、(75.10±8.87)分、(81.24±9.10)分](P<0.05);两组患者术后并发症发生率分别为10.00%和13.33%,差异无显著性(P>0.05)。结论 MIPO治疗胫骨Pilon骨折的效果较好,骨折愈合时间短,患者踝关节功能恢复良好。

Objective To investigate the role of minimally invasive plate osteosynthesis （MIPO） in the treatment of tibial Pilon fractures. Method 60 patients with tibial Pilon fractures treated in our hospital from January 2013 to December 2015 were selected as the subjects, the patients were randomly divided into observation group and control group, 30 cases in each group, control group patients were treated with limited open reduction and locking compression plate （LCP）; on the basis of the control group, observation group patients were treated with MIPO, operation related index, treatment effects, and the ankle joint function score 1 month, 3 months and 6 months after the operation of the two groups were compared. Result The operation time of observation group [（121.52 ±20.42） min] was significantly longer than that of control group [（95.07 ±18.16） min] （P〈 0.05）; fracture union time of observation group [（65.42 ±12.1 0） days] was significantly shorter than that of control group [（80.11 ± 10.46） days] （P〈0.05）; there was no significant difference in amount of bleeding during operation and hospital day between the two groups （P〈0.05）; the excellent and good rate of observation group （93.33%） was higher than that of control group （70.00%） （P 〈 0.05）; the ankle joint function score 1 month, 3 months and 6 months after operation of observation group [（72.21± 7.69） points, （81.43± 9.24） points, （90.08± 9.68） points] were significantly higher than that of control group at the same time [（63.48 ± 8.69） points, （75.10 ± 8.87） points, （81.24 ±9.1 0） points] （P〈 0.05）; postoperative complications of the two groups were 10.00% and 13.33%, there was no significant difference （P 〈 0.05）. Conclusion MIPO in the treatment of tibial Pilon fracture has good effect, the fracture healing time is short, the ankle ioint function recovers well.