微创经皮锁定钢板内固定治疗胫腓骨骨折患者的临床疗效评价

Evaluation on the clinical efficacy of minimally invasive percutaneous locking plate internal fixation in the treatment of 75 patients with tibial and fibular fractures

目的探讨微创经皮锁定钢板内固定治疗胫腓骨骨折患者的临床疗效。方法选择我院2018年1月~2019年1月收治的75例患者随机分为观察组(n=38)和对照组(n=37)。对照组给予切开复位钢板内固定治疗,观察组给予微创经皮锁定钢板内固定治疗。观察比较两组的优良率、手术时间、切口长度、透视次数及骨愈合时间等一般手术指标,并发症发生情况。结果观察组优23例(60.53%)、良10例(26.32%)、可4例(10.53%)、差1例(2.63%),整体临床疗效优于对照组(Z=-2.618,P=0.009);优良率为86.84%明显高于对照组的64.86%(χ^2=4.964,P=0.026)。观察组手术时间(70.13±8.64)min、切口长度(3.38±0.75)cm、骨愈合时间(4.69±0.53)月,各项指标明显优于对照组(t=-13.073,P=0.000;t=-36.150,P=0.000;t=-21.133,P=0.000);观察组的透视次数多于对照组(t=16.926,P=0.000)。观察组内固定松动断裂、创伤性关节炎等并发症发生率5.26%,明显低于对照组的21.62%(χ^2=4.341,P=0.037)。结论微创经皮锁定钢板内固定治疗胫腓骨骨折临床疗效显著、牢固性好;可有效缩短手术时间、促进骨愈合、恢复踝关节功能,并发症少、安全性高,值得推广应用。

Objective To explore the clinical effect of minimally invasive percutaneous locking plate internal fixation for the patients with tibial and fibular fractures.Methods 75 patients who were admitted to our hospital from January 2018 to January 2019 were randomly divided into an observation group(n=38)and a control group(n=37).The control group was given open reduction plate internal fixation,and the observation group was given minimally invasive percutaneous locking plate internal fixation.General surgical indicators,such as the excellent and good rate,operation time,incision length,fluoroscopy frequency,and bone healing time,as well as the incidence of complications were observed and compared between the two groups.Results In the observation group,23 cases were excellent(60.53%),10 cases were good(26.32%),4 cases were fair(10.53%),and 1 case was poor(2.63%).The overall clinical efficacy was better than that in the control group(Z=-2.618,P=0.009);the excellent and good rate was 86.84%,significantly higher than that of 64.86%in the control group(χ^2=4.964,P=0.026).The operation time in the observation group was(70.13±8.64)min,the incision length was(3.38±0.75)cm,and the bone healing time was(4.69±0.53)months.All indicators were significantly better than those in the control group(t=-13.073,P=0.000;t=-36.150,P=0.000;t=-21.133,P=0.000);the frequency of fluoroscopy was more than that in the control group(t=16.926,P=0.000).The incidence of complications such as loosening and breakage of internal fixation and traumatic arthritis in the observation group was 5.26%,which was significantly lower than that of 21.62%in the control group(χ^2=4.341,P=0.037).Conclusion Minimally invasive percutaneous locking plate internal fixation in the treatment of tibial and fibular fractures has a significant clinical effect and good firmness;it can effectively shorten the operation time,promote bone healing,restore the function of the ankle joint,has fewer complications,and has a high safety,which is worthy of popularization and application.