手法闭合复位经皮微创固定与小腿下段前外侧入路切开复位内固定治疗胫骨中下段骨折的疗效对比

Comparative study of percutaneous minimally invasive fixation and conventional lower calyx lateral anterograde approach with internal fixation for the treatment of middle and lower tibial fractures

目的探讨手法闭合复位经皮微创固定与常规小腿下段前外侧入路切开复位内固定治疗胫骨中下段骨折的疗效。方法选取2014年12月至2016年12月苏州市相城区中医医院骨科收治的胫骨中下段骨折病人110例,按随机数字表法分为两组,每组55例。对照组行常规小腿下段前外侧入路切开复位内固定治疗,观察组行手法闭合复位经皮微创固定治疗。对比分析两组临床疗效、手术情况、术后疼痛程度和并发症情况。结果观察组治疗优良率高于对照组(92.73%比72.73%),差异有统计学意义(P<0.05);观察组手术时间、术中出血量、切口长度、骨折愈合时间少于对照组,差异有统计学意义(P<0.05);观察组术后第1天、第15天、第30天术后疼痛程度评分低于对照组,差异有统计学意义(P<0.05);观察组并发症发生率3.64%低于对照组21.82%,差异有统计学意义(P<0.05)。结论手法闭合复位经皮微创固定治疗胫骨中下段骨折疗效优于常规小腿下段前外侧入路切开复位内固定治疗,可显著改善手术效果,减轻术后疼痛,促进骨折愈合,降低并发症发生率,值得推广。

:Objective To investigate the effect of manual reduction and percutaneous minimally invasive fixation and conventional lower calyx lateral anterograde approach and internal fixation for the treatment of middle and lower tibial fractures.Methods From December 2014 to December 2016,110 patients with lower tibial fractures were divided into two groups according to the number of random numbers.The control group was treated with conventional anterolateral approach and lower calyx underwent reduction and internal fixation.The observation group was treated with closed reduction and percutaneous minimally invasive fixation.The clinical efficacy,operation,postoperative pain and complications were analyzed.Results The excellent and good rate of the observation group was higher than that of the control group(92.73%vs.72.73%),the difference was statistically significant(P<0.05).The operative time,intraoperative blood loss,incision length and fracture healing time were shorter in the observation group than those in the control group.The difference was statistically significant(P<0.05).The scores of pain after the first day,the fifteen day and the thirty day after operation were lower than those of the control group.The difference was statistically significant(P<0.05).The incidence of complications in the observation group was lower than that in the control group(3.64%vs.21.82%),the difference was statistically significant(P<0.05).Conclusion The method of closed reduction and percutaneous minimally invasive fixation for the treatment of middle and lower tibial fractures is superior to conventional anterolateral approach of lower calyx underwent reduction and internal fixation.It can significantly improve the operation effect,reduce postoperative pain,promote fracture healing and reduce the incidence of complications rate,which is worthy of promotion.