MIPPO与ORIF治疗胫骨远端粉碎性骨折的比较研究  

Comparison of MIPPO versus ORIF in the treatment of comminuted fractures of distal tibia

作　　者：陈伟练[1] CHEN Weilian(Department of Orthopaedics, Nansha Hospital of Guangzhou First People's Hospital,Guangzhou, Guangdong 510000, China)

机构地区：[1]广州市第一人民医院南沙医院骨科,510000

出　　处：《中国骨科临床与基础研究杂志》2017年第4期223-228,共6页Chinese Orthopaedic Journal of Clinical and Basic Research

摘　　要：目的探讨经皮微创钢板接骨术(MIPPO)与切开复位内固定(ORIF)治疗胫骨远端粉碎性骨折患者围手术期血清碱性成纤维细胞生长因子(bFGF)和骨形成蛋白(BMP)-2的变化及疗效差异。方法将2013年5月至2016年4月广州市第一人民医院南沙医院收治的80例胫骨远端粉碎性骨折患者,按照随机数字表法随机分为MIPPO组(采用MIPPO治疗)和ORIF组(采用ORIF手术),每组各40例,比较两组患者围手术期血清bFGF、BMP-2水平及手术效果、踝关节功能恢复和并发症发生情况。结果 MIPPO组手术时间、术中出血量、骨折愈合时间及术后并发症发生率均少于ORIF组,踝关节功能恢复优良率高于ORIF组,两组比较,差异有统计学意义(P<0.05);术前两组患者血清bFGF、BMP-2水平无明显差异(P>0.05),术后2 d血清bFGF、BMP-2水平均升高,MIPPO组升高程度大于ORIF组,差异有统计学意义(P<0.05)。结论与ORIF术式相比,MIPPO技术治疗胫骨远端粉碎性骨折具有创伤小、手术时间短、骨折愈合快、功能恢复好、术后并发症少的优势,检测围手术期bFGF和BMP-2水平可能对评估骨折术后恢复情况有重要的临床意义。Objective To examine perioperative serum levels of basic fibroblast growth factor(bFGF)andbone morphogenetic protein(BMP)-2in patients with comminuted distal tibial fractures treated by minimallyinvasive percutaneous plate osteosynthesis(MIPPO)or open reduction internal fixation(ORIF),and to comparethe difference of therapeutic effect between two procedures.Methods Eighty patients with comminuted distaltibial fractures treated from May2013to April2016in Nansha Hospital of Guangzhou First People's Hospital,were randomly divided into MIPPO group(treated by MIPPO,n=40)and ORIF group(treated by ORIF,n=40)according to the method of random number table.Perioperative serum bFGF,BMP-2levels as well as operation effects,ankle joint function recovery and complications were compared between two groups.ResultsOperation time,intraoperative estimate blood loss,fracture healing time and incidence of complications inMIPPO group were lower than those in ORIF group,the excellent and good rate of ankle joint function washigher than that in ORIF group,the differences between two groups were statistically significant(P<0.05).Preoperative bFGF and BMP-2levels in two groups were similar(P>0.05);At2d after the surgery,bFGF andBMP-2levels in both groups were all increased,while those in MIPPO group improved more significantly(P<0.05).Conclusions Compared with ORIF,MIPPO technique in the treatment of comminuted distal tibial fractureshas the advantages of less trauma,short operation time,rapid fracture healing,good functional recovery and lesspostoperative complications;Detection of serum bFGF and BMP-2levels may provide clinical value inevaluating postoperative recovery for patients with fractures.

关 键 词：胫骨骨折 骨折 粉碎性 骨折固定术 内 外科手术 微创性 骨板 成纤维细胞生长因子2 骨形态发生蛋白质类 

分 类 号：R687.3[医药卫生—骨科学]