微创经皮钢板固定术治疗胫骨远端关节外骨折疗效及对骨折愈合时间的影响研究

Study on the effect of minimally invasive percutaneous plate fixation on the treatment of fracture of distal tibial joint and the time of fracture healing

目的探讨微创经皮钢板固定术治疗胫骨远端关节外骨折疗效及对骨折愈合时间的影响。方法选取2018年7月—2020年7月大余县人民医院收治的胫骨远端关节外骨折患者82例,按随机数字表法分为观察组(n=41)与对照组(n=41),对照组采用交锁髓内钉术治疗,观察组采用微创经皮钢板固定术治疗。对比2组优良率、围术期情况、并发症发生率、术前及术后24 h血清炎症因子[白细胞介素-1(IL-1)、肿瘤坏死因子-α(TNF-α)]水平。结果观察组优良率为95.12%,较对照组的80.49%高(P<0.05);观察组术中出血量较对照组少,手术时间、骨折愈合时间较对照组短(P<0.05);观察组并发症发生率为4.88%,较对照组的19.51%低(P<0.05);术后24 h,观察组血清TNF-α、IL-1水平较对照组低(P<0.05)。结论微创经皮钢板固定术治疗胫骨远端关节外骨折患者,可提高优良率,缩短手术时间,减少术中出血量,减轻炎性应激,降低并发症发生率,加快骨折愈合。

Objective To investigate the effect of minimally invasive percutaneous plate fixation on distal tibial fractures and the time of fracture healing.Methods 82 patients with distal tibial fractures from July~2018 to July 2020,They were divided into observation group(n=41)and control group(n=41),The control group was treated with interlocking intramedullary nailing,The observation group was treated with minimally invasive percutaneous plate fixation.the excellent and good rate,perioperative conditions,incidence of complications,serum inflammatory factors[interleukin-1(IL-1),tumor necrosis factor-α(tnf-α)]levels were compared between the two groups.Results 95.12%(39/41)of the observation group was higher than 80.49%(33/41)of the control group(P<0.05);Blood loss was less in the observation group than in the control group,operation time and fracture healing time were shorter than those in the control group(P<0.05);The incidence of complications in the observation group was 4.88%(2/41)lower than that in the control group(P<0.05);24 h,postoperatively The serum TNF-α、IL-1 level in the observation group was lower than that in the control group(P<0.05).Conclusion Minimally invasive percutaneous plate fixation for distal tibial fractures,Can improve the excellent rate,Shortening the operation time,Reduce intraoperative bleeding,Reducing inflammatory stress,Reduce the incidence of complications,Accelerate fracture healing.