MIPPO技术联合前外侧单一切口入路Ⅰ期治疗胫腓骨远端开放性骨折疗效观察

Clinical effect of MIPPO technique combined with anterolateral single incision approach in the treatment of open distal tibiofibular fractures

目的研究微创经皮钢板内固定(MIPPO)技术联合前外侧单一切口入路Ⅰ期治疗胫腓骨远端开放性骨折的临床疗效。方法选取延安市中医医院2018年1月至2020年6月期间收治的60例胫腓骨远端开放性骨折患者作为研究对象,按照随机数表法将患者分为研究组和对照组各30例。对照组患者采用前外侧单一切口入路Ⅰ期治疗,研究组患者在对照组治疗的基础上采用MIPPO技术联合治疗。比较两组患者的术中出血量、手术时间,治疗后骨折愈合时间;比较两组患者治疗前和治疗9个月后的Mazur(1979)踝关节评分;治疗9个月后比较两组患者的治疗效果;治疗1个月后比较两组患者的并发症发生情况。结果研究组患者的术中出血量、手术时间分别为(235.2±12.6)mL、(121.6±7.5)min,明显多(长)于对照组的(164.6±8.9)mL、(86.9±6.4)min,而骨折愈合时间为(16.8±4.7)周,明显短于对照组的(21.4±5.2)周,差异均有统计学意义(P<0.05);治疗前,两组患者的Mazur踝关节评分比较差异无统计学意义(P>0.05),治疗后,两组患者的Mazur踝关节评分均明显升高,且研究组患者的Mazur踝关节评分为(94.8±4.1)分,明显高于对照组的(89.4±3.9)分,差异均有统计学意义(P<0.05);研究组患者治疗后的总优良率为93.33%,明显高于对照组的70.00%,差异有统计学意义(P<0.05);研究组患者的并发症总发生率为3.33%,明显低于对照组的23.33%,差异有统计学意义(P<0.05)。结论MIPPO技术联合前外侧单一切口入路Ⅰ期治疗胫腓骨远端开放性骨折可有效改善患者的踝关节功能,降低术后并发症发生率,临床治疗效果显著。

Objective To study the clinical effect of minimally invasive percutaneous plate osteosynthesis(MIPPO)combined with anterolateral single incision approach in the treatment of open distal tibiofibular fractures.Methods A total of 60 patients with open distal tibiofibular fractures treated in Yan'an Hospital of Traditional Chinese Medicine from January 2018 to June 2020 were selected as the research objects.According to random number table method,the patients were divided into the study group and the control group,with 30 cases in each group.The patients in the control group were treated by anterolateral single incision approach,and the patients in the study group were treated with MIPPO technology on the basis of the treatment in the control group.The amount of bleeding,operation time,and fracture healing time after treatment were compared between the two groups;the Mazur(1979)ankle scores before and 9 months after treatment were compared between the two groups;after 9 months of treatment,the curative effects of the two groups were compared;after one month of treatment,the complications of the two groups were compared.Results The blood loss and operation time of the study group were(235.2±12.6)mL and(121.6±7.5)min,which were significantly more than/longer than corresponding(164.6±8.9)mL and(86.9±6.4)min of the control group(P<0.05),and the fracture healing time was(16.8±4.7)weeks,which was significantly shorter than(21.4±5.2)weeks of the control group(P<0.05).Before treatment,there was no significant difference in the Mazur ankle score between the two groups(P>0.05).After treatment,the Mazur ankle score of the two groups was significantly improved,and the Mazur ankle score of the study group was(94.8±4.1)points,which was significantly higher than(89.4±3.9)points of the control group(P<0.05).The total excellent and good rate of the study group was 93.33%,which was significantly higher than 70.00%of the control group(P<0.05).The total incidence of complications in the study group was 3.33%,which was significantly lower than 23.33%in the control group(P<0.05).Conclusion In the treatment of open distal tibiofibular fractures,MIPPO combined with anterolateral single incision approach can effectively improve the ankle function,reduce the incidence of postoperative complications,and bring significant the clinical treatment effect,which has significant clinical application value.