有限切开复位结合MIPO治疗胫腓骨干C型骨折  

Clinical Observation of Limited Open Reduction Combined with MIPO in Treatment of C-type Fracture of Tibia and Fibula

作　　者：杨磊[1] 王岩民[1] YANG-Lei;WANG Yan-min(Department of Orthopedics,North Hospital of Xinjiang Uygur Autonomous Region People's Hospital,Urumqi(830054),China)

机构地区：[1]新疆维吾尔自治区人民医院北院骨二科,乌鲁木齐830054

出　　处：《中国中西医结合外科杂志》2018年第4期451-455,共5页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

摘　　要：目的:分析胫腓骨干C型骨折有限切开复位结合经皮微创接骨板(MIPO)技术治疗的疗效。方法:回顾性分析86例胫腓骨干C型骨折患者的临床资料,根据是否采取有限切开复位结合MIPO技术治疗分为两组,观察组46例采取有限切开复位结合MIPO技术治疗,对照组40例采取传统切开复位内固定治疗。术后随访4~12个月,比较两组手术情况、住院时间、骨折愈合时间、并发症发生情况,根据Johner-Wruhs疗效评分标准评定疗效。结果:观察组手术时间、术中出血量、住院时间、骨折愈合时间均优于对照组(P<0.05);观察组切口愈合良好,未出现骨折延迟愈合、骨折不愈合、钢板外露、皮肤坏死;对照组骨折延迟愈合发生率25.0%,骨折不愈合发生率10.0%,钢板外露发生率5.0%,皮肤坏死发生率10.0%(P<0.01);观察组Johner-Wruhs疗效优良率93.5%,对照组80.0%(P<0.05)。结论:有限切开复位结合MIPO技术治疗胫腓骨干C型骨折,可获得良好的临床疗效,创伤性小,骨折愈合快,安全性高,显著改善患肢功能。Objective To analyze the clinical efficacy of limited open reduction combined with MIPO in the treatment of C-type fracture of tibia and fibula.Methods The clinical data of 86 patients with C-type fracture of tibia and fibula were retrospectively analyzed,in which 46 cases were given minimally invasive osteosynthesis combined with LCP(observation group),while 40 cases were given traditional open reduction and plate fixation(control group).The operation,hospital stay,fracture healing time and complications were compared between the two groups at the follow-up of 4–12 months after operation.The curative efficacy was compared between the two groups according to Johner-Wruhs efficacy score.Results The operation time,intraoperative blood loss,hospitalization time and fracture healing time in the observation group were significantly better than those in the control group(P<0.05).The incision healed well in the observation group without delayed union,nonunion,exposure of the steel plate and necrosis of the skin.The incidences of fracture healing,nonunion of fracture,plate exposed and skin necrosis were 25.0%,10.0%,5.00%and 10.0%,respectively(P<0.01).The excellent and good rate of Johner-Wruhs in the observation group was significantly higher than that in the control group(P<0.05).Conclusion Limited open reduction combined with MIPO technique for treating C-type fracture of tibia and fibula is an effective therapy with the advantages of less traumatic,fast fracture healing and high safety.It can significantly improve limb function.

关 键 词：胫腓骨干C型骨折 切开复位 微创 接骨板 

分 类 号：R683.42[医药卫生—骨科学]