MIPPO技术微创内固定联合膝关节镜治疗SchatzkerⅠ-Ⅲ型胫骨平台骨折的临床观察

Clinical observation of MIPPO minimally invasive internal fixation combined with knee arthroscopy in the treatment of Schatzker type Ⅰ-Ⅲ tibial plateau fractures

目的:观察微创经皮钢板接骨术(Minimally invasive percutaneous piate osteosyndesis,MIPPO)技术微创内固定联合膝关节镜治疗SchatzkerⅠ-Ⅲ型胫骨平台骨折(Tibial plateau fractures,TPF)的临床效果。方法:选取2021年1月~2023年12月我院收治的60例SchatzkerⅠ-Ⅲ型TPF患者,根据手术方式不同,将接受切开复位内固定(Open reduction and internal fixation,ORIF)治疗的患者纳入对照组(n=30),接受MIPPO技术微创内固定联合膝关节镜治疗的患者纳入观察组(n=30),观察两组围术期指标、美国特种外科医院(Hospital for special surgery,HSS)膝关节评分、血液流变学及并发症。结果:观察组切口大小、术中出血量、住院时间及骨折愈合时间均较对照组少(P<0.05)。术后1 m及术后2 m,观察组患者HSS膝关节评分高于对照组(P<0.05)。术后7 d观察组全血比黏度、血浆比黏度及红细胞沉降率较对照组低(P<0.05)。观察组术后并发症总发生率为3.33%,低于对照组的20.00%(P<0.05)。结论:MIPPO技术微创内固定联合膝关节镜治疗SchatzkerⅠ-Ⅲ型TPF患者的切口小、术中失血少、术后恢复快,能有效改善患者术后膝关节功能与血液流变学,且术后并发症少,值得推荐。

Objective:To observe the clinical effect of minimally invasive percutaneous plate osteosynthesis(Minimally invasive percutaneous piate osteosyndesis,MIPPO)technique combined with knee arthroscopy in the treatment of Schatzker type I-III tibial plateau fractures(Tibial plateau fractures,TPF).Method:Sixty Schatzker type I-III TPF patients admitted to our hospital from January 2021 to December 2023 were selected.According to different surgical methods,patients who received open reduction and internal fixation(Open reduction and internal fixation,ORIF)treatment were included in the control group(n=30),while patients who received MIPPO minimally invasive internal fixation combined with knee arthroscopy treatment were included in the observation group(n=30).Perioperative indicators,HSS(Hospital for special surgery,HSS)knee joint score,hemorheology,and complications were observed in both groups.Result:The observation group had fewer incision sizes,intraoperative bleeding,hospital stay,and fracture healing time compared to the control group(P<0.05).One month and two months after surgery,the HSS knee joint score of the observation group was higher than that of the control group(P<0.05).The whole blood viscosity,plasma viscosity,and erythrocyte sedimentation rate in the observation group were lower than those in the control group 7 days after surgery(P<0.05).The total incidence of postoperative complications in the observation group was 3.33%,lower than the control group's 20.00%(P<0.05).Conclusion:The combination of MIPPO technology with minimally invasive internal fixation and knee arthroscopy for the treatment of Schatzker type I-III TPF patients has a small incision,less intraoperative blood loss,and fast postoperative recovery.It can effectively improve postoperative knee joint function and hemorheology in patients,with fewer postoperative complications,and is worthy of recommendation.