微创内固定系统LISS与解剖钢板治疗复杂型胫骨中下段骨折疗效比较

A comparative study of Less Invasive Stabilization System LISS and anatomic plate in treatment of complex fractures of the lower tibia

目的探讨微创内固定系统(LISS)与解剖钢板治疗复杂型胫骨下段骨折的临床疗效比较。方法选取2013年10月至2016年12月我院收治的复杂型胫骨下段骨折患者90例,按随机数表法分为对照组和观察组,每组45例,对照组采取解剖钢板内固定治疗,观察组采取LISS钢板内固定治疗。比较两组患者手术时间、术中出血量、住院时间、骨折愈合时间、术后开始负重时间以及术后的并发症总发生率。结果对照组和观察组患者治疗后疗效的优良率分别为86.7%、91.1%,组间比较差异无统计学意义(P>0.05);观察组患者手术时间、住院时间、骨折愈合时间、术后开始负重时间均短于对照组[(85.5±15.2)min vs(94.5±14.9)min、(7.1±3.0)d vs(9.3±3.4)d、(3.1±1.5)个月vs(4.2±1.6)个月、(32.6±3.7)d vs(41.2±4.6)d],术中出血量低于对照组[(180.5±37.8)m L vs(250.3±44.5)m L],组间比较差异均具有统计学意义(P<0.05);观察组患者术后并发症总发生率为6.7%,低于对照组的22.2%,差异具有统计学意义(P<0.05)。结论胫骨中下段骨折患者采用微创内固定系统LISS钢板与解剖钢板内固定治疗的疗效相近,但LISS钢板内固定治疗在负重时间、骨折愈合时间上的优势更明显,患者功能恢复更快,并具有手术时间短、并发症少等优点。

Objective To compare the therapeutic effect of the Less Invasive Stabilization System（LISS） and anatomic plate in the treatment of complex fractures of the lower tibia. Methods A total of 90 patients with complex tibial fractures, who admitted in our hospital from October 2013 to December 2016, were selected and divided into the control group and the observation group according to random number table method, with forty-five patients in each group. The control group was treated with anatomic plate for internal fixation; the observation group used LISS for internal fixation. The operative time, intraoperative blood loss, hospital stay, fracture healing time, postoperative weight-bearing time and postoperative complication rate were compared between the two groups. Results The excellent and good rate of the control group and the observation group were 86.7% and 91.1% respectively, with no significant difference between the two groups（P〈0.05）. The operative time, hospital stay, fracture healing time, postoperative weight-bearing time, intraoperative blood loss in the observation group were（85.5±15.2） min,（7.1±3.0） d,（3.1±1.5） months,（32.6±3.7）,（180.5±37.8） m L, respectively, which were significantly shorter or lower than corresponding（94.5±14.9） min,（9.3±3.4） d,（4.2±1.6） months,（41.2±4.6） d,（250.3±44.5） m L in the control group（P〈0.05）. The overall incidence of postoperative complications was 6.7% in the observation group, which was significantly lower than that 22.2% in the control group（P〈0.05）. Conclusion Less Invasive Stabilization System（LISS） plate fixation and anatomical plate fixation have similar therapeutic effect in the treatment of complex fractures of the lower tibia, but LISS plate fixation has the obvious advantages of shorter fracture healing time and postoperative weight-bearing time for faster function recovery, shorter operation time and less complication.