微创锁定加压钢板术治疗胫腓骨远端骨折  

Effects of minimally invasive locking compression plate on joint function and complication in distal tibiofibular fracture

作　　者：莫征然 周干溪 王井旺 郭春荣 Mo Zhengran;Zhou Ganxi;Wang Jingwang;Guo Chunrong(Department of Orthopeadic Surgery, Yangshan People′s Hospital, Qingyuan 513100, China)

机构地区：[1]阳山县人民医院骨外科,清远513100

出　　处：《中华关节外科杂志（电子版）》2020年第3期334-338,共5页Chinese Journal of Joint Surgery(Electronic Edition)

摘　　要：目的探讨微创锁定加压钢板术对胫腓骨远端骨折(DTF)患者关节功能及并发症的影响。方法选取2017年1月至2018年12月阳山县人民医院DTF患者75例,纳入A3型DTF诊断、年龄>18岁、知情同意者,排除有本次手术治疗禁忌证或有骨关节炎、骨肿瘤等其他骨病或其他部位骨折者。依据随机数字表法分为微创组(n=38)和开放手术组(n=37),微创组给予微创锁定加压钢板术治疗,开放手术组给予开放性复位锁定加压钢板术治疗,计数资料采用卡方检验,等级资料采用秩和检验,计量资料采用t检验,比较两组手术情况、骨折愈合、关节功能、并发症。结果微创组切口长度、术中出血量、住院时间、骨折愈合时间明显低于开放手术组,差异有统计学意义(t=13.771、5.697、12.431、15.644,均为P<0.05),微创组手术时间高于开放手术组,但差异无统计学意义(P>0.05);微创组骨折愈合、关节功能优良率明显高于开放手术组,差异有统计学意义(X^2=4.789、3.973,均为P<0.05);微创组并发症发生率明显低于开放手术组,差异有统计学意义(X^2=4.341,P<0.05)。结论微创锁定加压钢板术治疗DTF的疗效良好,有利于促进患者骨折愈合、关节功能恢复,且可减少并发症,值得临床推广。Objective To discuss the effect of minimally invasive locking compression plate on the joint function and complication in the patients with distal tibiofibular fracture(DTF).Methods A total of 75 patients with DTF were selected from January 2017 to December 2018 in Yangshan People′s Hospital,the patients diagnosed as type A3 DTF,age>18 years old and informed consent were included.The patients with contraindications of this operation,osteoarthritis,bone tumor and other bone diseases or fractures of other parts were excluded.According to the random number table method,they were divided into group A(n=38)and group B(n=37).The group A were treated with minimally invasive locking compression plates,and the group B were treated with open reduction locking compression plates.The chi-square test is used for counting data,the rank sum Z test is used for rank data,and the t test is used for measurement data,the operation conditions,fracture healing,joint function and complications were compared between the two groups.Results The incision length,intraoperative blood loss,length of hospital stay and fracture healing time in the group A were significantly lower than those in the group B,the difference was statistically significant(t=13.771,5.697,12.431,15.644,all P<0.05),the operation time in the group A was higher than that in the group B,but the difference was not statistically significant(P>0.05).The excellent rate of fracture healing and joint function in the group A were significantly higher than those in the group B,the difference was statistically significant(X^2=4.789,3.973,both P<0.05).The complication rate in group A was significantly lower than that in the group B,the difference was statistically significant(X^2=4.341,P<0.05).ConclusionMinimally invasive locking compression plate is effective for DTF,which can promote fracture healing,joint function recovery and reduce complications,it’s worth for further clinical promotion.

关 键 词：外科手术 微创性 骨板 胫骨骨折 踝关节 骨折 多处 手术后并发症 

分 类 号：R68[医药卫生—骨科学]