踝关节面有限切开复位微创接骨术结合锁定钢板内固定对胫骨Pilon 骨折预后的影响  

The impact of MIPO combined with locking plate fixation for the prognosis of patients with fractures of the tibia and Pilon

作　　者：王占国[1] 

机构地区：[1]北京大学首钢医院骨科,北京市110041

出　　处：《中国基层医药》2015年第13期1992-1995,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的：探讨踝关节面有限切开复位微创接骨术（MIPO）结合锁定钢板内固定治疗对胫骨 Pilon骨折预后的影响。方法将84例经 CT 或 X 线检查确诊为胫骨 Pilon 骨折患者采用随机数字表法分为 A 组及 B 组各42例，A 组采用 MIPO 结合锁定钢板内固定治疗，B 组采用切开复位内固定治疗，术后对两组患者进行临床及影像学随访，对比分析两组疗效、并发症。结果A 组术中出血量少于 B 组（t ＝8．963，P ＜0．05），术后疼痛评分低于 B 组（t ＝10．789，P ＜0．05），而满意度评分高于 B 组（t ＝8．963，P ＜0．05），术后住院时间、骨折愈合时间短于 B 组（t ＝9．362，10．556，P ＜0．05）。根据 Conroy 评分系统及 Tenny 评分系统，A 组优、良率分别为95．24％、76．19％，均高于 B 组的92．86％、71．43％，差异均有统计学意义（χ2＝6．222、6．574，均 P ＜0.05）。A 组总并发症发生率（2．38％）显著低于 B 组（21．43％）（χ2＝7．265，P ＜0．05）。结论MIPO 结合锁定钢板内固定治疗 Pilon 骨折可减少软组织剥离，减少手术对患者的创伤，降低患者术后并发症，有利于患者尽早康复。Objective To investigate the impact of minimally invasive osteosynthesis （MIPO）combined with locking plate fixation for the prognosis of patients with fractures of the tibia and Pilon.Methods 84 patients with CT or X -ray diagnosis of tibial Pilon fracture were randomly divided into group A （n =42）and group B （n =42）. The group A were threatment with MIPO combination locking plate fixation and group B were threatment with reduction and internal fixation.The following -up clinical and radiological data of the two groups were compared. Results The blood loss of group A were less than group B（t =8.963,P 〈0.05）,postoperative pain score were lower than group B（t =10.789,P 〈0.05）,while the satisfaction score was higher than group A （t =8.963,P 〈0.05）, postoperative hospital stay,healing time were shorter than group B （t =9.362,10.556,all P 〈0.05）.The Conroy scoring system and Tenny scoring system of A group of excellent rates were 95.24%,76.19% were higher than 92.86% and 71.43% of group B（χ2 =6.222,6.574,all P 〈0.05）.The overall complication rate of A group was lower than the group B（χ2 =7.265,P 〈0.05 ）.Conclusion MIPO combination of locking plate fixation Pilon fractures can reduce soft tissue dissection,reduce surgical trauma to the patient,reduce postoperative complications in patients,in favor of patients recover as soon as possible.

关 键 词：踝关节面有限切开 微创接骨术 锁定钢板内固定 胫骨骨折 

分 类 号：R687.3[医药卫生—骨科学]