MIPPO联合LCP内固定对胫骨远端骨折术后相关指标的影响

Influence of MIPPO combined with LCP internal fixation on postoperative related indexes of distal tibial fracture

目的探讨微创钢板接骨(MIPPO)联合锁定加压钢板(LCP)内固定对胫骨远端骨折患者血清碱性磷酸酶(ALP)及炎性因子水平的影响。方法以随机数字表法,将2017年7月至2019年6月收治的90例胫骨远端骨折患者分组,对照组45例,采用传统切开复位解剖型钢板内固定治疗,观察组45例,采用MIPPO联合LCP内固定治疗,对两组患者治疗优良率、血清ALP及炎性因子水平进行比较分析。结果观察组治疗优良率为91.11%,与对照组71.11%对比,显著较高(P<0.05);术前两组血清ALP水平对比,无显著差异(P>0.05),术后48小时,观察组血清ALP水平与对照组对比,显著较高(P<0.05);术前两组白介素-1(IL-1)、肿瘤坏死因子-α(TNF-α)水平对比,无显著差异(P>0.05),术后48小时,观察组上述指标水平与同期对照组对比,明显较低(P<0.05)。结论胫骨远端骨折采用MIPPO联合LCP内固定治疗,效果确切,可改善血清ALP水平,减轻炎性反应,值得推广。

Objective To investigate the effect of minimally invasive percutaneous plate osteosynthesis(MIPPO)combined with locking compression plate(LCP)internal fixation on serum alkaline phosphatase(ALP)and inflammatory factors in patients with distal tibial fracture.Methods 90 patients with distal tibial fracture treated from July 2017 to June 2019 were divided into two groups by random number table.45 patients in the control group were treated with traditional open reduction and internal fixation with anatomical plate.45 patients in the observation group were treated with MIPPO combined with LCP internal fixation.The excellent and good rate of treatment,the level of serum ALP and inflammatory factors were compared between the two groups.Results The excellent and good rate of the observation group was 91.11%,which was significantly higher than that of the control group 71.11%(P<0.05).There was no significant difference in serum ALP level between the two groups before operation(P>0.05).48 hours after operation,the level of serum ALP in the observation group was significantly higher than that in the control group(P<0.05).There was no significant difference in the levels of interleukin-1(IL-1)and tumor necrosis factor-alpha(TNF-alpha)between the two groups before operation(P>0.05).48 hours after operation,the above indicators in the observation group were significantly lower than those in the control group during the same period(P<0.05).Conclusion MIPPO combined with LCP internal fixation for distal tibial fracture has a definite effect.It can improve the level of serum ALP and alleviate inflammatory reaction.It is worth popularizing.