微创经皮钢板接骨术与切开复位内固定术治疗胫骨中下段骨折对比研究  

Comparative of minimally invasive percutaneous plate osteosynthesis and open reduction and internal fixation in repair of distal tibia fracture

作　　者：龚辉[1] 朱东波[1] 丁剑锋[1] 盛小明[1] 

机构地区：[1]南通大学附属医院急诊科,江苏南通226001

出　　处：《中国医学前沿杂志（电子版）》2016年第2期68-73,共6页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：江苏省教育厅科技计划项目(J14L29)

摘　　要：目的采取回顾性研究方法探讨微创经皮钢板接骨术（minimally invasive percutaneous plate osteosynthesis,MIPPO）和切开复位内固定术（open reduction and internal fixation,ORIF）治疗胫骨中下段闭合性骨折的临床效果。方法选取2012年7月至2014年12月本院53例胫骨中下段新鲜闭合性骨折患者为研究对象,经MIPPO治疗20例患者纳入MIPPO组,经ORIF治疗33例患者纳入ORIF组,比较两组患者的手术时间、术中出血量、切口长度、住院时间、骨折愈合时间、并发症发生情况以及末次随访Johner-Wruh评分。结果两组患者均随访11~30个月,术后均获得较满意的治疗效果,MIPPO组患者术中出血量少于ORIF组（P〈0.01）,切口长度小于ORIF组（P〈0.01）,手术时间、住院时间及骨折愈合时间均短于ORIF组（P〈0.01）。两组患者术后并发症发生率及术后末次随访的Johner-Wruh评分比较均无显著差异（P〉0.05）。结论 MIPPO和ORIF治疗胫骨中下段闭合性骨折效果均较满意,但MIPPO操作更为简单,创伤较小,利于骨折愈合。Objective To investigate the clinical effect of minimally invasive percutaneous plate osteosynthesis（MIPPO） and open reduction and internal fixation（ORIF） in the treatment of tibial fractures in middle and distal segment. Method From July 2012 to December 2014, 53 cases used MIPPO and ORIF technology for the treatment of distal tibia fracture in our hospital, 20 cases were treated with MIPPO（MIPPO group）, 33 cases were treated with ORIF（ORIF group）, operation time, length of incision, amount of bleeding, length of stay, healing time of fracture, Johner-Wruh score and postoperative complications between the two groups were observed. Result All patients were followed-up 11 ~ 30 months, amount of bleeding of MIPPO group was less than ORIF group（P〈0.01）, length of incision of MIPPO group was smaller than ORIF group（P〈0.01）, operation time, ength of stay and healing time of fracture of MIPPO group were shorter than ORIF group（P〈0.01）. There were no significant differences in Johner-Wruh score and postoperative complications between the two groups（P〉0.05）. Conclusion MIPPO and ORIF in the treatment of tibial fractures are satisfactory, but MIPPO is more simple, less trauma and conducive to fracture healing.

关 键 词：微创经皮钢板接骨术 切开复位内固定术 胫骨骨折 

分 类 号：R687.3[医药卫生—骨科学]