经皮微创钢板与外固定支架治疗Gustilo Ⅱ型胫腓骨骨折比较研究  

Minimally invasive percutaneous plate and external fixationg for the treatment of type Gustilo Ⅱ fractures of tibia and fibula

作　　者：周智[1] 左文山[1] 谢跃[1] 王黎明[2] 

机构地区：[1]南京医科大学附属淮安第一医院骨科,江苏淮安223300 [2]南京医科大学附属南京医院骨科,210000

出　　处：《疑难病杂志》2014年第11期1152-1155,共4页Chinese Journal of Difficult and Complicated Cases

基　　金：国家自然科学基金资助项目(No.81171745)

摘　　要：目的比较经皮微创钢板固定技术(MIPPO)和外固定支架固定术治疗GustiloⅡ型胫腓骨骨折的疗效。方法选择65例GustiloⅡ型胫腓骨骨折患者,根据手术方式不同分为MIPPO组(33例)和外固定支架组(32例)。比较2组手术时间、术中出血量、肿胀消退时间、骨折愈合时间,评价优良率及术后并发症发生情况。结果MIPPO组与外固定支架组术中出血量、肿胀消退时间比较无明显差异(P>0.05),而MIPPO组较外固定支架组手术时间短,差异有统计学意义(P<0.05),术后骨折愈合时间,MIPPO组较外固定支架组明显缩短(P<0.05)。术后并发症发生率2组比较差异无统计学意义(21.2%vs.21.9%,P>0.05),但MIPPO组中发生感染例数相对较多。末次随访MIPPO组优良率亦明显优于外固定支架(90.9%vs.78.1%,P<0.05)。结论经皮微创钢板固定技术和外固定支架固定术治疗GustiloⅡ型胫腓骨骨折均有良好的临床疗效。经皮微创钢板固定技术手术时间短,骨折愈合相对快,远期疗效佳,而外固定支架治疗感染的发生率低。Objective To compare the effect of minimally invasive percutaneous plate osteosynthesis （ MIPPO） and external fixation technique in the treatment of Gustilo type II fractures of tibia and fibula.Methods Sixty-five cases of Gustilo type II fractures of tibia and fibula patients were enrolled , according to the operation mode , they were divided into MIPPO group （33 cases） and external fixator group （32 cases.The operation time, bleeding volume, postoperative 2 groups swel-ling subsided time , healing time of fracture , the excellent and good rate and postoperative complications were compared be-tween the two groups.Results The amount of bleeding , swelling time showed no significant difference between the MIPPO group and external fixation group （ P〉0.05）, MIPPO group’s operation time is shorter than the external fixator group , the difference was statistically significant （ P 〈0.05）, postoperative fracture healing time in MIPPO group was significantly shor-tened compared with the external fixator group （ P 〈0.05.The incidence of postoperative complications has no significant difference （2.2% v.2.9%, P〉0.05） between the 2 groups, but the minimally invasive percutaneous plate fixation group has relatively more cases of infection.The last time follow-up showed that minimally invasive percutaneous plate fixation group’s excellent and good rate was also significantly more than external fixator group （9.9%v.7.1%, P 〈0.05.Con-clusion Both minimally invasive percutaneous plate fixation and external fixation for the treatment of Gustilo type II of tibial and fibula fractures have good clinical curative effect.Minimally invasive percutaneous plate osteosynthesis revealed shorter operation time , fracture healing is relatively fast , long-term effect is good , but the incidence of infection of fixation for the treatment is low.

关 键 词：经皮微创钢板固定技术 外固定支架 胫腓骨骨折 Gustilo II型 

分 类 号：R687.3[医药卫生—骨科学]