交锁髓内钉固定术与微创经皮钢板固定术治疗胫骨远端关节外骨折的效果对照分析

Comparative Analysis of the Effect of Interlocking Intramedullary Nail Fixation and Minimally Invasive Percutaneous Plate Osteosynthesis in the Treatment of Distal Tibial Extrarticular Fractures

目的比较微创经皮钢板固定术(Minimally Invasive Percutaneous Plate Osteosynthesis,MIPPO)与交锁髓内钉固定术(Interlocking Intramedullary Nail,IMN)治疗胫骨远端关节外骨折的效果。方法选取2022年5月—2023年4月菏泽医学专科学校附属医院就诊的94例胫骨远端关节外骨折患者为研究对象,按照随机数表法分为两组,每组47例。对照组采取IMN治疗,研究组采取MIPPO治疗。比较两组术中情况及康复指标、美国纽约特种外科医院膝关节评分(Hospital for Special Surgery,HSS)与Olerud-Molander踝关节功能评分(Olerud-Molander Ankle Score,OMAS)以及术后并发症情况。结果与对照组结果比较,研究组术中失血量更少,住院时间与术后愈合时间更短,差异有统计学意义(P均<0.05)。术后6个月两组HSS、OMAS评分对比,差异无统计学意义(P均>0.05)。研究组术后并发症发生率为4.26%,较对照组的19.15%低,差异有统计学意义(χ^(2)=5.045,P<0.05)。结论IMN与MIPPO对于胫骨远端关节外骨折患者踝关节与膝关节的改善效果相当,但MIPPO能够减少术中失血量,缩短康复进程,降低术后并发症发生率。

Objective To compare the efficacy of minimally invasive percutaneous plate osteosynthesis(MIPPO)and interlocking intramedullary nail(IMN)in the treatment of distal tibia extraarticular fractures.Methods A total of 94 patients with distal tibial extrasarticular fracture treated in the Affiliated Hospital of Heze Medical College from May 2022 to April 2023 were selected as the research objects and were divided into two groups according to random num⁃ber table method,with 47 cases in each group.The control group was treated with IMN and the study group with MIPPO.Intraoperative conditions and rehabilitation indexes,Hospital for Special Surgery(HSS)score,Olerud-Molander Ankle Score(OMAS)and postoperative complications were compared between the two groups.Results Com⁃pared with the control group,the study group had less intraoperative blood loss,shorter hospital stay and postoperative healing time,and the differences were statistically significant(all P<0.05).There was no significant difference in HSS and OMAS scores between the two groups 6 months after operation(both P>0.05).The incidence of postoperative com⁃plications in the study group was 4.26%,which was lower than that in the control group(19.15%),and the difference was statistically significant(χ^(2)=5.045,P<0.05).Conclusion IMN and MIPPO have similar improvement effects on ankle and knee joints in patients with distal tibial extrasarticular fractures,but MIPPO can reduce intraoperative blood loss,shorten the rehabilitation process,and reduce the probability of postoperative complications.