微创经皮钢板接骨术联合锁定加压钢板内固定在四肢骨折患者中的临床应用

Clinical application of minimally invasive percutaneous plate osteotomy combined with locking compression plate internal fixation in patients with extremities fracture

目的:探讨微创经皮钢板接骨术(MIPPO)联合锁定加压钢板(LCP)内固定治疗四肢骨折的临床疗效。方法:选取2015年7月至2017年4月北京市房山区良乡医院收治的91例四肢骨折患者,依据手术术式不同分为观察组和对照组,对照组45例采用切开复位加钢板内固定治疗,观察组46例采用MIPPO联合LCP治疗,观察比较两组手术情况(术中出血量、手术时长、骨折愈合时间)、康复效果及术后6周体积有机质含量(VOC)、骨小梁数量(Tb.N),并统计两组术后并发症发生情况。结果:观察组手术时长、骨折愈合时间明显短于对照组,术中出血量明显低于对照组,差异具有统计学意义(P<0.05);观察组康复优良率为97.83%,高于对照组的80.00%(P<0.05);观察组术后6周VOC、Tb.N明显高于对照组(P<0.05),并发症发生率明显低于对照组(P<0.05)。结论:MIPPO联合LCP可减少四肢骨折患者术中出血量,缩短手术时长及术后骨折愈合时间,改善骨质量,康复效果显著,可降低术后并发症发生率。

Objective: To evaluate the clinical effect of minimally invasive percutaneous plate osteotomy (MIPPO) combined with locking compression plate (LCP) internal fixation in treatment of extremities fracture. Methods: From July 2015 to April 2017, 91 patients with fracture of extremities were divided into an observation group (n=45) and a control group (n=45). Patients in the observation group received MIPPO combined with LCP treatment, and those in control group received open reduction and plate internal fixation treatment. The intraoperative blood-loss volume, operation time, fracture healing time, rehabilitation effect, volume organic matter content (VOC), trabecular number (Tb.N) and postoperative complications were observed and compared. Results: The operative time and healing time of fracture in the observation group were significantly shorter than those in the control group, and the volume of bleeding in the observation group was less than that in the control group (P<0.05). The excellent and good rate of rehabilitation in the observation group was 97.83%, which was higher than that in the control group (80.00%)(P<0 05). The VOC and Tb.N of the observation group at 6 weeks after operation was higher than that of control group, and the incidence of complications was significantly lower (P<0 05). Conclusion: MIPPO combined with LCP could reduce the bleeding volume, shorten the operation time, promote fracture healing, improve the bone quality, and reduce the incidence of postoperative complications in patients with fracture of extremities.