应用微创经皮接骨板内固定技术与带锁髓内钉治疗开放性C2型胫骨骨折的临床疗效比较  

A comparative study of minimally invasive percutaneous plate versus interlocking intramedullary nail osteosynthesis in treatment of open C2 tibial fracture

作　　者：白祥[1,2] 禹宝庆[1,2] 顾龙殿[1,2] 王永安[1,2] 瞿卫[1,2] 

机构地区：[1]上海市浦东医院 [2]复旦大学附属浦东医院骨科,上海201399

出　　处：《中国骨与关节外科》2014年第5期363-366,共4页Chinese Journal of Bone and Joint Surgery

基　　金：上海市浦东新区卫生系统重点专科建设资助项目(PWZZ2013-09)

摘　　要：背景：胫骨开放性骨折在临床上比较常见,并发症多、治疗困难,采取何种治疗方法,尤其是内固定方法,目前尚无统一认识。目的：探讨应用微创经皮接骨板内固定技术（MIPPO）与带锁髓内钉（IMN）治疗开放性C2型胫骨骨折的临床疗效。方法：2010年1月至2013年12月,选择性应用MIPPO和IMN技术治疗开放性C2型胫骨骨折89例,其中应用MIPPO治疗52例,应用IMN治疗37例,观察两组患者的手术时间、骨折临床愈合时间、术后并发症,采用Johner-Wruh胫骨骨折疗效评估标准评估患肢功能,评定应用MIPPO和IMN技术治疗开放性C2型胫骨骨折的临床疗效。结果：所有患者均获得随访,随访时间为11~34个月,平均23.4个月。MIPPO组和IMN组的平均手术时间为71 min和65 min;平均愈合时间为（34.6±8.3）周和（32.1±9.6）周。MIPPO组出现2例感染、1例成角畸形、1例延迟愈合、1例不愈合;IMN组出现1例感染、1例旋转畸形、1例不愈合,两组术后并发症总发生率比较无统计学差异（P〉0.05）。结论：MIPPO和IMN技术是治疗开放性C2型胫骨骨折的两种理想方法。Background： Open fracture of tibia is very common in clinic. But it is difficult to be treated because of high incidence of complications, and there has not been unified understanding to the choice of treatment methods, especially for internal fixation. Objective： To explore clinical outcomes of minimally invasive percutaneous plate osteosynthesis （MIPPO） and interlocking intramedullary nail （IMN） in treating open tibial fracture. Methods： Between January 2010 and December 2013, 52 patients with tibial fracture underwent MIPPO and 37 received IMN. All the open fractures were type C2. Operation time, healing time of fractures and postoperative complications were recorded. The function of affected extremities were evaluated by Johner-Wruh score. Results： The mean duration of follow-up was 23.4 months in all patients （range, 11-34 months）. The operation time was 71 min in MIPPO group and 65 min in IMN group. The healing time was （34.6±8.3） weeks in MIPPO group and （32.1±9.6） weeks in IMN group. In MIPPO group, osteomyelitis occurred in 2 cases, malunion in 1, delayed union in 1 and nonunion in 1. In IMN group, osteomyelitis occurred in 1 case, malunion in 1 and nonunion in 1. There was no significant difference in the incidence of postoperative complications between MIPPO and IMN group （P〉0.05）. Conclusions： Both MIPPO and IMN are ideal therapies for open C2 tibial fracture

关 键 词：微创经皮接骨板内固定技术 带锁髓内钉 胫骨骨折 内固定 

分 类 号：R687.3[医药卫生—骨科学]