微创经皮接骨板与交锁髓内钉治疗胫骨中下段骨折的临床效果对比

Clinical Comparison of Minimally Invasive Plate Osteosynthesis and Interlocking Intramedullary Nail in the Treatment of Middle and Lower Tibial Fractures

目的:比较微创经皮接骨板(MIPO)与交锁髓内钉手术治疗胫骨中下段骨折患者的临床效果。方法:选择2016年8月-2021年8月南京医科大学附属逸夫医院骨科收治的80例胫骨中下段骨折患者作为研究对象,采用随机数字表法分为试验组(n=40)、对照组(n=40)。试验组采用MIPO手术治疗,对照组采用交锁髓内钉手术治疗。比较两组一般手术指标、骨折治疗效果、并发症发生情况及关节功能评分。结果:试验组手术时间、骨折愈合时间、住院时间均短于对照组,术中出血量少于对照组,差异均有统计学意义(P<0.05)。试验组与对照组的术后并发症发生率比较,差异无统计学意义(P>0.05)。术后6个月,试验组与对照组骨折治疗效果优良率比较,差异无统计学意义(P>0.05)。术后6个月,试验组与对照组的美国特种外科医院(HSS)膝关节功能评分比较,差异无统计学意义(P>0.05),但试验组的Olerud-Molander踝关节功能评分高于对照组,差异有统计学意义(P<0.05)。结论:微创接骨板手术治疗胫骨中下段骨折患者与交锁髓内钉手术疗效相近,对保障患者骨折愈合效果均有积极价值,但微创接骨板手术时间更短,患者骨折愈合速度更快且踝关节功能恢复效果更好,值得深入研究。

Objective:To compare the clinical effects of minimally invasive plate osteosynthesis(MIPO)and interlocking intramedullary nail in the treatment of middle and lower tibial fractures.Method:A total of 80 patients with middle and lower tibial fractures who were admitted to the Department of Orthopedics,Yifu Hospital Affiliated to Nanjing Medical University from August 2016 to August 2021 were selected as the research subjects,and they were divided into the experimental group(n=40)and the control group(n=40)by random number table method.The experimental group was treated with MIPO and the control group was treated with interlocking intramedullary nail.The general surgical indexes,fracture treatment effect,complications and joint function score were compared between the two groups.Result:The operation time,fracture healing time and hospital stay in the experimental group were shorter than those in the control group,and the intraoperative blood output was less than that in the control group(P<0.05).There was no significant difference in the incidence of postoperative complications between the experimental group and the control group(P>0.05).Six months after operation,there was no significant difference in the excellent and good rate of fracture treatment between the experimental group and the control group(P>0.05).Six months after operation,there was no significant difference in HSS knee function score between the experimental group and the control group(P>0.05).However,the Olerud-Molander ankle function score in the experimental group was significantly higher than that in the control group(P<0.05).Conclusion:The curative effect of minimally invasive plate surgery in the treatment of middle and lower tibial fractures is similar to that of interlocking intramedullary nail,which is of positive value in ensuring the effect of fracture healing,but the minimally invasive plate operation time is shorter,the fracture healing speed of patients is faster,and the recovery effect of ankle function is better,which is worthy of in-depth study.