微创经皮钢板固定术与交锁髓内钉治疗胫骨远端关节外骨折疗效差异

To Observe the Effect of Minimally Invasive Percutaneous Plate Osteosynthesis and Interlocking Intramedullary Nail in the Treatment of Distal Tibial Extra-articular Fractures

观察分析微创经皮钢板固定术(MIPPO)与交锁髓内钉(IMN)治疗胫骨远端关节外骨折的临床疗效。以2011年2月~2015年12月期间笔者所在医院骨科收治的134例符合胫骨远端关节外骨折诊断标准的患者作为研究对象,随机分为MIPPO组(n=67)和IMN组(n=67),MIPPO组给予MIPPO治疗,IMN组给予IMN治疗;观察两组患者术中治疗情况、术后临床疗效和并发症等。结果,MIPPO组患者手术时间、住院时间较IMN组均显著缩短,住院费用较高(P<0.05)。两组术中出血量、愈合时间无明显差异(P>0.05)。MIPPO组患者和IMN组患者治疗有效率均能达到90%以上,治愈率高,能够有效减轻患者痛苦;MIPPO组患者并发症发生率低(9.0%),无愈合延期、畸形等并发症,预后情况较佳,优于IMN组(P<0.05)。MIPPO疗效突出,并发症少,能有效缩短手术时间并降低对骨组织的损伤,IMN法治疗费用低,不易感染,均对临床具有重要的意义。

To observe the clinical effect of minimally invasive percutaneous plate osteosynthesis （MIPPO） and interlocking intramedullary nail （IMN） in the treatment of distal tibial extra-articular fractures. A total of 134 patients with distal tibial extramedullary articular fractures were randomly divided into two groups： MIPPO group （n = 67） and IMN group （n = 67）. MIPPO group was treated with minimally invasive percutaneous plate osteosynthesis. IMN group was treated with interlocking intramedullary nail. The clinical effect and complication were observed in the two groups. MIPPO group was treated with minimally invasive percutaneous plate osteosynthesis. The operation time and hospital stay were significantly shorter than those of IMN group. The hospitalization cost was higher （P〈0.05）. There was no significant difference in blood loss and healing time between the two groups （P〉0.05）. MIPPO group and IMN group were more than 90% effective rate, high cure rate, can effectively reduce the pain of patients; MIPPO group patients with low incidence of complications （9.0 % ）, no healing delay, malformations and other complications, prognosis （P〈0.05）, which was better than IMN group. Minimally invasive percutaneous plate osteosynthesis is an effective method to shorten the operation time and reduce the damage of bone tissue. The treatment of interlocking intramedullary nailing is of low cost and difficult to infect. It is of great clinical significance.