微创经皮钢板固定术治疗胫骨远端关节外骨折的临床效果观察

目的 探讨微创经皮钢板固定术(MIPPO)治疗胫骨远端关节外骨折的临床效果.方法 选取2012年1月至2013年2月我院骨科收治的80例胫骨远端关节外骨折患者,随机分为MIPPO组和交锁内定组(IMN组),IMN组采用IMN方法治疗,MIPPO组采用MIPPO方法治疗,比较两组患者手术时间、术中出血量、骨折愈合时间,两组患者均随访1年,采用足踝功能评分(AOFAS评分),并统计并发症发生情况.结果 MIPPO组手术时间、术中出血量、骨折愈合时间少于IMN组(65.3±21.3) minvs.(89.1±22.5) min,(16.8±3.6) ml vs.(22.4±4.1) ml,(16.8±2.2)周vs.(19.5±2.1)周,P＜0.05].MIPPO组术后3、6、12月足踝功能评分高于IMN组(75.3±6.5)分vs.(62.7±6.6)分,(81.3±5.4)分vs.(74.2±5.8)分,(88.9±5.1)分vs.(79.6±5.7)分,P＜0.05].MIPPO组并发症发生率低于IMN组(12.50％ vs.32.50％,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可减少手术时间、术中出血量及并发症,促进骨折愈合,具有显著临床治疗效果,值得在临床中推广应用.

Minimally invasive percutaneous plate fixation for articular distal tibial fractures

Objective To evaluate the clinical effect of minimally invasive percutaneous plate fixation (MIPPO) for articular distal tibial fractures.Methods 80 patients with distal tibial articular fracture admitted into the department of orthopedics at our hospital January, 2012 to February, 2013 were selected and were randomly divide into an MIPPO group and an IMN group., The IMN group were treated with interlocking default (IMN) method and the MIPPO group MIPPO method.The operation time, intra-operative bleeding volume, and fracture healing time were compared between these two groups.Both groups were followed up to get their 1-year use of ankle function score (AOFAS score).The incidences of complications in both groups were statistically calculated.Results The operation time and fracture healing time were shorter and the intra-operative bleeding volume was lower in the MIPPO group than in the IMN group (65.3 ± 21.3) min vs.(89.1 ± 22.5) min, (16.8 ± 2.2) weeks vs.(19.5 ± 2.1) weeks, (16.8 ± 3.6) ml (22.4 ± 4.1) ml, P＜0.05].3, 6, and 9 months after the operation, the ankle function score was higher in the MIPPO group than in the IMN group (75.3 ± 6.5) vs.(62.7 ± 6.6), (81.3 ± 5.4) vs.(74.2 ± 5.8), and (88.9 ± 5.1) vs.(79.6 ± 5.7), P＜0.05].The incidence of complications was lower in the MIPPO group than in the IMN group (12.50％ vs.32.50％, P ＜0.05).Conclusions Minimally invasive percutaneous plate fixation for articular distal tibial fractures can reduce operation time, intra-operative bleeding volume, and the incidence of complications and promote healing and is clinically effective and worth being clinically generalized.