经皮微创接骨板内固定术治疗四肢骨折患者的效果观察

Observation on Effect of Percutaneous Minimally Invasive Bone Plate Internal Fixation in the Treatment of Limb Fracture

目的:探讨经皮微创接骨板内固定术(MIPPO)治疗四肢骨折患者的临床效果。方法:选择2018年4月-2022年1月三明市第二医院收治的四肢骨折患者96例,按随机数字表法将其分为传统切开复位内固定(ORIF)组与MIPPO组,各48例。ORIF组采取切开复位接骨板内固定术治疗,MIPPO组采取MIPPO治疗,持续观察至术后3个月。比较两组治疗效果、手术相关指标、疼痛程度[视觉模拟评分法(VAS)]、炎症因子[C反应蛋白(CRP)、降钙素原(PCT)]水平及并发症发生情况。结果:MIPPO组优良率为95.83%,高于ORIF组的81.25%,手术时间为(49.60±7.85)min、切口长度为(4.25±0.65)cm,均短于ORIF组的(84.25±11.32)min、(13.21±1.76)cm,术中出血量为(84.80±13.54)mL,低于ORIF组的(147.41±28.36)mL,差异均有统计学意义(P<0.05)。MIPPO组术后第1、3天VAS评分分别为(4.84±1.20)、(2.57±0.83)分,均低于ORIF组的(5.72±1.63)、(3.69±1.15)分,差异均有统计学意义(P<0.05)。术后3 d,两组CRP、PCT水平均高于术前,但MIPPO组均低于ORIF组(P<0.05)。MIPPO组术后并发症发生率为6.25%,低于ORIF组的29.17%,差异有统计学意义(P<0.05)。结论:MIPPO治疗四肢骨折的效果确切,可减轻患处炎症反应与疼痛程度,有利于骨折愈合,且微创性高,术后并发症少。

Objective: To investigate the clinical efficacy of minimally invasive percutaneous plate internal fixation(MIPPO) in the treatment of extremity fracture. Method: A total of 96 patients with limb fractures admitted to Sanming Second Hospital from April 2018to January 2022 were selected and divided into traditional open reduction and internal fixation(ORIF) group and MIPPO group according to random number table method, 48 patients in each group. ORIF group was treated with open reduction and internal fixation of bone plate, and MIPPO group was treated with MIPPO, and continued observation until 3 months after surgery. The treatment effect, operation related indexes, pain degree [visual analogue scale(VAS)], inflammatory factor levels [C-reactive protein(CRP), procalcitonin(PCT)] and complications were compared between the two groups. Result: The excellent and good rate in MIPPO group was 95.83%, which was higher than 81.25% in ORIF group, the operation time was(49.60±7.85) min, the incision length was(4.25±0.65) cm, which were shorter than(84.25±11.32) min and(13.21±1.76) cm in ORIF group, the intraoperative bleeding volume was(84.80±13.54) mL, which was lower than(147.41±28.36) mL in ORIF group, and the differences were statistically significant(P<0.05). The VAS scores of MIPPO group on the first and third day after operation were(4.84±1.20) and(2.57±0.83) points respectively, which were lower than(5.72±1.63) and(3.69±1.15) points of ORIF group, and the differences were statistically significant(P<0.05). At 3 d after operation, the levels of CRP and PCT in two groups were higher than those before operation, but those in MIPPO group were lower than those in ORIF group(P<0.05). The incidence of postoperative complications in MIPPO group was 6.25%, which was lower than 29.17% in ORIF group,the difference was statistically significant(P<0.05). Conclusion: MIPPO is effective in the treatment of limb fracture, which can reduce the inflammatory reaction and pain degree of the affected area, and is beneficial to fracture healing, with high minimally invasive and less postoperative complications.