胫骨中下段骨折患者应用经皮钳夹复位下MIPPO内侧锁定钢板治疗的效果及对生活质量和骨代谢指标水平的影响

Effect of MIPPO Medial Locking Plate on Quality of Life and Bone Metabolism in Patients with Middle and Lower Tibial Fractures Treated with Percutaneous Clamp Reduction

目的:探讨经皮钳夹复位下MIPPO内侧锁定钢板治疗胫骨中下段骨折患者的效果及对骨代谢指标水平及生活质量的影响。方法:选取2020年1月-2021年5月在本院治疗的胫骨中下段骨折患者60例,随机分为两组,每组30例。对照组应用髓内钉内固定治疗,研究组应用经皮钳夹复位下MIPPO内侧锁定钢板治疗,比较两组骨代谢指标、手术结果、血栓发生率、瘀斑、疼痛与肿胀评分及生活质量。结果:研究组术后3个月的DPD、OPG、ALP水平均高于对照组,差异均有统计学意义(P<0.05)。两组住院时间、愈合时间比较,差异均无统计学意义(P>0.05)。研究组术中出血量少于对照组,手术时间短于对照组,血栓发生率低于对照组,差异均有统计学意义(P<0.05)。研究组术后3个月的瘀斑评分、疼痛评分、肿胀评分均低于对照组,差异均有统计学意义(P<0.05)。术前,两组的心理健康、角色功能、社会功能、躯体功能评分比较,差异均无统计学意义(P>0.05);术后3个月,两组的心理健康、角色功能、社会功能、躯体功能评分均高于术前,且研究组上述评分均高于对照组,差异均有统计学意义(P<0.05)。结论:应用经皮钳夹复位下MIPPO内侧锁定钢板治疗胫骨中下段骨折患者效果良好,可以有效缩短患者的愈合时间,降低血栓的发生率,同时可以改善患者的骨代谢、肿胀、疼痛和瘀斑情况,提高患者的生活质量。

Objective:To investigate the effect of percutaneous clamp reduction with MIPPO medial locking plate in the treatment of middle and lower segment tibia fracture and its effect on bone metabolism and quality of life.Method:A total of 60 patients with middle and lower tibial fractures treated in our hospital from January 2020 to May 2021 were randomly divided into two groups,30 cases in each group.The control group was treated with intramedullary nail internal fixation,and the study group was treated with MIPPO medial locking plate under percutaneous clamp reduction.The bone metabolic indexes,surgical results,incidence of thrombosis,ecchymosis,pain and swelling scores and quality of life were compared.Result:The levels of DPD,OPG and ALP in the study group 3 months after surgery were higher than those in the control group,the differences were statistically significant (P<0.05).There were no significant differences in hospital stay and healing time between the two groups (P>0.05).The amount of intraoperative blood loss in the study group was less than the control group,the surgery time was shorter than that of the control group,and the incidence of thrombosis was lower than that of the control group,the differences were statistically significant (P<0.05).The ecchymosis score,pain score and swelling score of the study group were lower than those of the control group 3 months after surgery,the differences were statistically significant (P<0.05).Before surgery,there were no significant differences in mental health,role function,social function and physical function scores between the two groups (P>0.05).3 months after surgery,the scores of mental health,role function,social function and physical function in both groups were higher than those before surgery,and those in the study group were higher than those in the control group,the differences were statistically significant (P<0.05).Conclusion:The application of percutaneous clamp reduction and reduction of MIPPO medial locking plate in the treatment of patients with middle and lower segment tibia fracture has a good effect,which can effectively shorten the healing time of patients,reduce the incidence of thrombosis,improve the bone metabolism,swelling,pain and ecchymosis of patients,and improve the quality of life of patients.