新型撑开器结合微创内固定系统内固定治疗胫骨近端骨折  

A new minimally invasive spreader combined with less invasive stabilization system for proximal tibial fractures

作　　者：黄俊明 刘小明[1] 李季蔓 钟伟斌 柳昱 朱豪东 Huang Junming;Liu Xiaoming;Li Jiman;Zhong Weibin;Liu Yu;Zhu Haodong(Department of Orthopedics(Part 1),Fifth Hospital,Guangzhou Medical University,Guangzhou 510730,Guangdong Province,China)

机构地区：[1]广州医科大学附属第五医院骨科一区,广东省广州市510730

出　　处：《中国组织工程研究》2020年第30期4818-4823,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:传统手术治疗方法治疗胫骨近端骨折对骨折部位剥离广泛,且影响局部血液循环,增加骨折延迟愈合和不愈合的发生率。近年来兴起的微创内固定系统,可以最大限度地保护局部软组织以及血液循环,为骨折愈合提供更好的条件,而新型撑开器的应用也解决了传统人手牵引复位稳定性、持久性的问题,两者的结合应用逐渐受到关注。目的:探讨新型撑开器辅助复位、微创内固定系统治疗胫骨近端骨折的疗效。方法:以2016年5月至2019年10月收治的22例胫骨近端骨折患者为研究,随机分为对照组和观察组,各11例。对照组采用传统手法复位、常规切口钢板内固定;观察组以新型撑开器辅助复位、微创内固定系统钢板内固定。试验经广州医科大学附属第五医院伦理委员会批准。结果与结论:与对照组相比,观察组患者末次随访时Rasmussen膝关节功能评分较优,术中失血量、手术用时、住院天数、开始负重时间较少,出现关节受限、骨折延迟愈合等术后并发症患者数量较少,但骨折愈合时间与对照组接近,且切口感染、内固定松动断裂等术后并发症患者数量与对照组接近。提示应用新型撑开器结合微创内固定系统内固定治疗胫骨近端骨折,可以减少手术复位时间、降低局部软组织损伤,有利于患者早期功能锻炼,减少手术后并发症。BACKGROUND:The traditional surgical treatment of proximal tibial fractures has extensive dissection of the fracture site,and affects local blood circulation,increases the incidence of delayed union and nonunion.In recent years,the rising minimally invasive internal fixation system can protect the local soft tissue and blood circulation to the maximum extent,and provide better conditions for fracture healing.The application of new spreader also solves the problems of stability and durability of traditional manual traction reduction,and the combination of the two is gradually concerned.OBJECTIVE:To explore the effect of a new minimally invasive spreader assisted reduction and less invasive stabilization system for the treatment of proximal tibial fractures.METHODS:Twenty-two patients with proximal tibial fractures treated from May 2016 to October 2019 were studied and randomly assigned to control group and observation group(n=11 per group).Patients in the control group were treated with conventional manipulative reduction and conventional incision plate internal fixation.Patients in the observation group were treated with a new minimally invasive spreader assisted reduction and less invasive stabilization system.This study was approved by the Ethics Committee of Fifth Hospital,Guangzhou Medical University.RESULTS AND CONCLUSION:Compared with the control group,Rasmussen knee function score was better in the observation group at the last follow-up.Intraoperative blood loss,operation time,length of hospital stay,and weight-bearing time in the observation group were better than those in the control group.Postoperative complications such as joint limitation and delayed fracture healing were less in the observation group than in the control group.However,the healing time was not statistically significant between the two groups.Moreover,infection of the incision and loosening and fracture of the internal fixator were not statistically significant between the two groups.These indicated that the application of a new minimal

关 键 词：新型撑开器 胫骨近端骨折 生物力学 胫骨力线 膝关节功能评分 微创内固定系统内固定 并发症 早期功能锻炼 

分 类 号：R459.9[医药卫生—治疗学] R365[医药卫生—临床医学]