皮外钢板技术与微创接骨板技术治疗胫骨远端粉碎性骨折  

Comparsion of minimally invasive percutaneous osteosynthesis and supercutaneous plating with closed reduction in treatment of distal tibial comminuted fractures

作　　者：贺小兵[1] 李克俭[1] 冉广文[1] 赵刚[1] 

机构地区：[1]重庆市涪陵中心医院骨科,重庆408000

出　　处：《局解手术学杂志》2016年第8期592-595,共4页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的 探讨皮外钢板技术与微创接骨板技术治疗胫骨远端粉碎性骨折的临床效果。方法 选取我院2012年4月至2014年4月40例胫骨远端粉碎性骨折患者,按手术方法分为皮外钢板固定组和微创接骨板技术组,每组20例。皮外钢板固定组采用皮外钢板技术治疗,微创接骨板技术组采用微创接骨板技术治疗,比较2组患者的手术时间、住院时间、术后负重时间、骨折愈合时间、并发症发生率及踝关节的功能评分。结果 皮外钢板固定组手术时间（60.17±5.64）min,住院时间（8.651±2.21）d,术后负重时间（49.26±9.85）d,骨折愈合时间（13.82±4.23）周,并发症发生率5.00%,治疗优良率95.00%;微创接骨板技术组手术时间（74.64±6.82）min,住院时间（18.22±2.32）d,术后负重时间（57.56±11.32）d,骨折愈合时间（17.47±2.31）周,并发症发生率25.00%,治疗优良率80.00%。2组手术时间（χ~2=9.922,P=0.007）、住院时间（χ~2=10.48,P=0.015）、术后负重时间（χ~2=14.618,P=0.001）及骨折愈合时间（χ~2=40.16,P=0.000）比较,差异具有统计学意义（P〈0.05）。踝关节功能评定按照AOFSA评分进行,皮外钢板技术组为（89.1±3.9）分,微创接骨板技术组为（90.5±4.1）分,2组比较差异无统计学意义（χ~2=0.463,P=0.793）。结论 皮外钢板技术与微创接骨板技术治疗胫骨远端粉碎性骨折中踝关节的功能术后都得到了很好的恢复,但皮外钢板技术治疗胫骨远端粉碎性骨折在手术时间、住院时间、术后负重时间及骨折愈合时间等方面均短于微创接骨板固定技术。Objective To compare the clinical efficacy of minimally invasive pereutaneous osteosynthesis and supercutaneous plating with closed reduction in the treatment of distal tibial eomminuted fractures. Methods A total of 40 patients with close distal tibial comminuted fractures in our hospital from April 2012 to April 2014 were divided into minimally invasive pereutaueous osteosynthesis group and external fixation group. External fixation group were treated by supercutaueous plating, while the minimally invasive pereutaneous osteosynthesis group were treated by minimally invasive percutaneous osteosynthesis. And the operative duration, hospital stay,the time of weight loading and frac- ture healing,postoperative complications and function of ankle were compared between the two groups. Results In the supercutaneous plating group,the operative duration was （60. 17 ±5.64） minutes, the hospital stay was （8. 651±2.21 ） days, the time of weight loading was （ 49.26±9.85 ） clays, the time of fracture healing was （ 13.82±4.23 ） weeks, the incidence of postoperative complications was 5.00% , and the excellent and good rates was 95.00%, In the minimally invasive percutaneous osteosynthesis group, the operative duration was （74.64±6.82 ） triinutes, the hospital stay was （ 18.22±2.32 ） days, the time of weight loading was （ 57.56±11.32 ） days, the time of fracture healing was （ 17.47±2.31 ） weeks, the incidence of postoperative complications was 25.00% , and the excellent and good rates was 80.00%. There were significant differences in operative duration （X2 = 9. 922, P = 0. 007 ）, hospital stay （X2 = 10.48, P = 0. 015 ） , time of weight loading （X^2 14. 618,P =0.001 ） and . 2 =40.16,P =0. the two = fracture heahng（x 000） between groups. The AOFSA score of supercutaneous plating group was （ 89.1±3.9） point, compared with （90.5±4.1 ） point of minimally invasive percutaneous osteosynthesis group, and the difference was statistically significant（x^2 = 0. 463 ,P = 0

关 键 词：胫骨 骨折 骨折固定术 接骨板 

分 类 号：R683.42[医药卫生—骨科学]