锁定加压接骨板结合微创经皮钢板内固定技术与交锁髓内钉治疗老年性胫骨中下段骨折

Locking compression plate combined with minimally invasive percutaneous plate fixation versus intramedullary interlocking nailing for senile distal tibia fractures

背景:锁定加压接骨板结合微创经皮钢板内固定技术用于治疗老年性胫骨中下段骨折的效果良好,可更好的修复骨折,有利于下肢功能恢复。目的:回顾性方法比较锁定加压接骨板结合微创经皮钢板内固定与交锁髓内钉内固定治疗老年性胫骨中下段骨折的临床效果。方法:56例胫骨中下段骨折的老年患者,根据内固定选择不同分为2组:锁定加压接骨板结合微创经皮钢板内固定病例28例为微创组,交锁髓内钉内固定术病例28例为髓内钉组;比较两组手术时间、内固定中出血量、内固定后AOFAS踝-后足量表评分、内固定后下地时间、骨折临床愈合时间、内固定后并发症及J-W优良率等。结果与结论:(1)微创组手术时间、AOFAS踝-后足量表评分、下地时间、骨折愈合时间均明显优于对照组(P<0.05);(2)微创组治疗优良率(96%)高于髓内钉组(79%)(P<0.05);(3)微创组并发症低于髓内钉组(P<0.05);(4)结果说明,锁定加压接骨板结合微创经皮钢板内固定治疗老年性胫骨中下段骨折最大程度的保留了骨折断端的血运,保护了骨折处周围软组织,符合BO原则,有利于骨折愈合,具有良好的临床效果。

BACKGROUND： In the treatment of senile distal tibia fractures, locking compression plate （LCP） combined with minimally invasive percutaneous plate osteosynthesis （MIPO） exerts a satisfactory repair effect, and contributes to the function recovery of lower limbs.OBJECTIVE： To retrospectively analyze the efficacy of LCP combined with MIPO versus intramedullary interlocking nailing for senile distal tibia fractures.METHODS： Fifty-six elderly patients with distal tibia fracture were allotted to minimally invasive and intramedullary nailing groups （n=28 per group）, and received the treatment of LCP combined with MIPO and intramedullary interlocking nailing fixation, respectively. The operation time, intraoperative blood loss, postoperative AOFAS ankle-hind foot scale scores, postoperative ambulation time, healing time, postoperative complications and the excellent and good rate in Johner-Wruhs＆#39; criteria were compared between two groups.RESULTS AND CONCLUSION： （1） The operation time, AOFAS ankle-hind foot scale scores, ambulation time, and healing time in the minimally invasive group were significantly superior to those in the intramedullary nailing group （P 〈 0.05）. （2） The minimally invasive group showed a significantly higher excellent and good rate （96%） than the intramedullary nailing group （79%） （P 〈 0.05）. （3） Compared with the intramedullary nailing group, the incidence of complications was significantly reduced in the minimally invasive group （P 〈 0.05）. （4） Our findings suggest that the combination of LCP and MIPO not only preserves the most of blood supply, and soft tissues surrounding the fracture end as suggested by the BO principle, but also is conducive for fracture healing, and holds good efficacy.