MIPPO技术辅以四柱分型理论治疗老年全膝关节置换术后RorabeckⅡ型骨折的临床研究

MIPPO technology supplemented with four-column classification theory in the treatment of Rorabeck typeⅡfractures in the elderly after total knee arthroplasty

目的分析MIPPO技术辅以四柱分型理论治疗全膝关节置换术(TKA)后RorabeckⅡ型骨折的安全性及可行性。方法纳入本院骨科于2010年1月至2020年1月期间收治的40例TKA术后RorabeckⅡ型骨折患者入组,随机抽签法分为两组,研究组(20例)采用四柱分型理论下MIPPO技术内固定,对照组(20例)采用传统切开复位内固定术,均随访至术后1年。观察并比较两组术中出血量、切口长度、骨折愈合时间,术后引流量及膝关节功能恢复情况。结果研究组手术时间、术中出血量、切口长度、术后引流量、骨折愈合时间均低于对照组[(85.01±6.34)min VS (105.36±8.89)min,t=11.787]、[(68.24±5.22)ml VS (79.26±10.90)ml,t=5.767]、[(8.03±2.57)cm VS (18.25±4.57)cm,t=12.328]、[(142.52±8.57)ml VS(173.51±10.50)ml,t=14.461]、[(3.67±1.04)月VS(5.81±3.06)月,t=14.461],(P均<0.05);研究组膝关节功能优良率均高于对照组(95.00%VS 70.00%,χ~2=4.329,P<0.05);治疗后研究组VAS评分小于对照组[(2.30±0.53)分VS(4.66±1.58)分,t=8.956,P<0.05];随访期间对照组发生3例内固定松动、2例关节强直、2例骨折不愈合,研究组出现1例伤口感染,治疗后好转,研究组并发症发生率低于对照组(χ~2=5.000,P=0.025)。结论 MIPPO技术辅以四柱分型理论有利于TKA术后RorabeckⅡ型骨折患者膝功能恢复,具有创伤小,痛苦小,术后恢复快,并发症少等优势。

Objective To analyze the safety and feasibility of MIPPO technology supplemented with four-column classification theory in the treatment of Rorabeck typeⅡfracture after total knee arthroplasty(TKA).Methods The operation time,intraoperative blood loss,incision length,postoperative drainage volume,and fracture healing time of the study group were all lower than the control group[(85.01±6.34)min VS(105.36±8.89)min,t=11.787],[(68.24±5.22)ml VS(79.26±10.90)ml,t=5.767],[(8.03±2.57)cm VS(18.25±4.57)cm,t=12.328],[(142.52±8.57)ml VS(173.51±10.50)ml,t=14.461],[(3.67±1.04)month VS(5.81±3.06)month,t=14.461],(P<0.05);the excellent rate of knee function in the study group was higher than that in the control group(95.00%VS 70.00%,c2=4.329,P<0.05);the VAS score of the study group after treatment was less than the control group[(2.30±0.53)score VS(4.66±1.58)points,t=8.956,P<0.05];during the follow-up period,3 cases of internal fixation loosening,2 cases of joint stiffness,and 2 cases of fracture nonunion occurred in the control group.One wound infection occurred in the study group,which improved after treatment.The incidence of complications was lower than the control group(χ~2=5.000,P=0.025).Conclusion The MIPPO technology supplemented with the four-column classification theory is conducive to the recovery of knee function in patients with Rorabeck typeⅡfractures after TKA.It has the advantages of less trauma,less pain,faster postoperative recovery,and fewer complications.