微创经皮与传统切开复位内固定治疗胫骨骨折疗效对比研究

Contrastive study of minimally invasive percutaneous and traditional open internal fixation technique in the treatment of tibial fracture

目的探讨微创经皮与传统切开复位内固定治疗胫骨骨折的临床疗效。方法选择深圳市坪山新区人民医院2015年2月至2016年12月收治的胫骨骨折患者162例,按随机数表法分为观察组和对照组,每组81例。对照组给予传统切开复位内固定治疗,观察组给予微创经皮复位内固定治疗,比较两组患者围术期相关指标、骨折愈合时间、关节功能恢复情况及术后并发症。结果观察组患者的手术时间、骨痂形成时间、住院时间、骨折临床愈合时间分别为(43.6±3.1)min、(10.1±1.2)周、(8.1±1.2)d、(13.2±1.5)d,均明显短于对照组的(77.8±3.2)min、(18.9±1.3)周、(17.1±1.1)d、(16.6±1.6)d,术中出血量为(74.3±9.4)m L,明显少于对照组的(212.2±9.7)m L,差异均具有显著统计学意义(P<0.01);观察组患者关节功能恢复优良率为95.1%,明显高于对照组的70.4%,差异具有统计学意义(P<0.05);观察组患者的钢板外露、骨折延迟愈合、软组织感染发生率均明显低于对照组,差异均具有统计学意义(P<0.05)。结论微创经皮复位内固定治疗胫骨骨折疗效显著,且具有创伤小、术中出血少、手术时间短、术后恢复快、关节功能恢复理想、并发症少的优势,值得临床推广。

Objective To contrasted the clinical effects of minimally invasive percutaneous and traditional open internal fixation technique in the treatment of tibial fracture. Methods A total of 162 patients with tibial fracture,who admitted to Pingshan New District People＇s Hospital of Shenzhen during February 2015 to December 2016, were selected and divided into the observation group and the control group, with 81 cases in each group. The control group were treated with traditional open internal fixation technique, and the observation group were treated with minimally invasive percutaneous internal fixation technique, then the perioperative related index, fracture healing time, recovery of joint function and the postoperative complications were contrasted between the two groups. Results The operation time, callus formation time, hospital stay, fracture healing time in the observation group were（43.6±3.1） min,（10.1±1.2） weeks,（8.1±1.2） d,（13.2±1.5） d, which were significantly shorter than（77.8±3.2） min,（18.9±1.3） weeks,（17.1±1.1） d,（16.6±1.6） d in the control group（P〈0.05）. The intraoperative blood loss of the observation group was（74.3 ± 9.4） m L, which was significantly less than（212.2±9.7） m L in the control group（P〈0.05）. The excellent rate of the recovery of joint function in the observation group was 95.1%, which was significantly higher than 70.4% in the control group（P〈0.05）. The incidence of exposure of steel plate, delayed union of fracture, soft tissue infection in the observation group were significantly lower than those in the control group（P〈0.05）. Conclusion Minimally invasive percutaneous reduction and internal fixation has an ideal effect in the treatment of tibial fractures, with less trauma, less bleeding, shorter operation time, fast postoperative recovery, ideal recovery of joint function, less postoperative complications, which is worthy of application.