腓骨后外侧入路联合微创经皮钢板内固定术治疗A3型胫腓骨远端骨折的前瞻性研究  

Effects of fibular posterolateral approach and minimally invasive percutaneous plate osteosynthesis on the short-term prognosis of the type A3 distal tibiofibular fractures

作　　者：毛丰[1] 郭志 郑军[1] 辛宗山[1] 李成真 胡伟 MAO Feng;GUO Zhi;ZHENG Jun;XIN Zong-shan;LI Cheng-zhen;HU Wei(Department of Orthopedics,People ＂s Hospital of Zhongxiang,Hubei,431900,China)

机构地区：[1]钟祥市人民医院骨科,湖北431900

出　　处：《中国骨与关节杂志》2018年第7期510-513,共4页Chinese Journal of Bone and Joint

摘　　要：目的分析腓骨后外侧入路联合微创经皮钢板内固定术(minimally invasive percutaneous plate osteosynthesis,MIPPO)治疗A3型胫腓骨远端骨折患者的临床疗效。方法根据不同术式将2016年5月至2017年8月我院收治的68例A3型胫腓骨远端骨折患者分为常规组(32例)和研究组(36例),常规组予以切开复位内固定治疗,研究组予以腓骨后外侧入路联合MIPPO治疗,并在术后12个月对两组患者进行随访,比较两组患者的手术指标、骨折愈合时间、并发症、生活质量、踝关节功能、X线Lane-Sandhu骨痂生产评分。结果研究组术中出血量、住院时间及骨折愈合时间均低于常规组,两组相比差异均有统计学意义(P=0.000,P=0.000,P=0.000);术后12个月,研究组Mazur评分及X线Lane-sandhu评分均高于常规组,差异有统计学意义(P=0.000,P=0.000);研究组并发症发生率低于常规组,两组相比差异有统计学意义(P=0.047)。结论相较于切开复位内固定,腓骨后外侧入路联合MIPPO治疗创伤小,骨折愈合时间短,并发症发生率低,显著改善了A3型胫腓骨远端骨折患者的近期预后,值得临床重视。Objective To analyze the effects of fibular posterolateral approach and minimally invasive percutaneous plate osteosynthesis（ MIPPO） on the short-term prognosis of the type A3 distal tibiofibular fractures. Methods From May 2016 to August 2017, 68 cases of type A3 distal tibiofibular fractures were collected. According to different surgical methods, all patients were divided into the convention group（ n = 32, treated by open reduction and internal fixation） and study group（ n = 36, treated by MIPPO）. Surgical index, fracture healing time, complications, quality of life, ankle joint function and X-ray Lane-Sandhu osteotylus were evaluated. Results The amount of bleeding, hospital stay, and the healing time of the fracture in the study group were less than those of the conventional group with statistical significance（ P = 0.000, P = 0.000, P = 0.000）. Twelve months after the operation, the Mazur score and X-ray Lane-sandhu score of the study group were all higher than those of the conventional group with statistical significance（ P = 0.000, P = 0.000）. The incidence of complications in the study group was lower than that of the conventional group with statistical significance（ P = 0.047）. Conclusions Compared with open reduction and internal fixation, the fibular posterolateral approach and MIPPO can shorten the time of fracture healing, reduce the incidence of complications, and significantly improve the short-term prognosis of A3 type distal tibiofibular fractures.

关 键 词：胫骨骨折 腓骨 骨折固定术 内 治疗结果 前瞻性研究 

分 类 号：R683.4[医药卫生—骨科学]