两种内固定治疗胫骨下段骨折的疗效比较  

The efficacy comparison of two kinds of internal fixation for treatment of the lower tibial fracture

作　　者：王华勇[1] 王平[1] WANG Hua-yong;WANG Ping(Dept of Orthopaedics, the First People′s Hospital of Zaoyang City,Xiangyang,Hubei 441200)

机构地区：[1]枣阳市第一人民医院骨科,湖北襄阳441200

出　　处：《临床骨科杂志》2021年第1期128-130,共3页Journal of Clinical Orthopaedics

摘　　要：目的比较带锁髓内钉(IMN)固定和微创经皮钢板内固定(MIPPO)治疗胫骨下段骨折的疗效。方法将140例胫骨下段骨折患者按手术方式不同分为IMN组(采用IMN固定治疗,70例)和MIPPO组(采用MIPPO治疗,70例)。比较两组手术情况及治疗效果。结果患者均获得随访,时间6~12(9.31±1.23)个月。术中出血量、术后6个月踝关节背伸角度两组比较差异均无统计学意义(P>0.05),手术时间及骨折愈合时间MIPPO组均短于IMN组(P<0.01)。并发症发生率MIPPO组为5.71%,低于IMN组的28.57%(P<0.05)。末次随访时手术疗效:MIPPO组愈合49例,好转17例,未愈合4例,有效率为94.28%;IMN组愈合37例,好转19例,未愈合14例,有效率为80.00%;两组有效率比较差异有统计学意义(P<0.05)。结论采用MIPPO治疗闭合胫骨下段骨折手术创伤小、术中出血量少、并发症发生率低,更利于患者康复。Objective To investigate the effect of interlocking intramedullary nail(IMN)and minimally invasive percutaneous plate osteosynthesis(MIPPO)fixation for treatment of lower tibial fractures.Methods The 140 patients with lower tibial fractures were divided into IMN group(adopting IMN,70 cases)and MIPPO group(adopting MIPPO,70 cases),according to different fixation methods.The operation situation and postoperative treatment effect were compared between two groups.Results All patients were followed up for 6~12(9.31±1.23)months.The intraoperative bleeding volume,dorsiflexion and extension angle of the ankle joint at postoperative 6 months had no statistical differences between two groups(P>0.05),the opertion time and postoperative fracture healing time of the MIPPO group were both shorter than those of IMN group(P<0.01).The complication incidence rate:MIPPO group was 5.71%,which was lower than 28.57%of IMN group(P<0.05).The surgery effect at the last follow-up:the MIPPO group was healed in 49 cases,turned better in 17 cases,and unhealed in 4 cases,the effective rate was 94.28%;the IMN group was healed in 37 cases,turned better in 19 cases,and unhealed in 14 cases,the effective rate was 80.00%,there was no difference for the effective rate between two groups(P<0.05).Conclusions Internal fixation with MIPPO for closed lower tibial fractures is less trauma,less intraoperative bleeding volume,and low complication incidence rate,which is benefit of the recovery of the patients.

关 键 词：微创经皮钢板内固定 带锁髓内钉 胫骨下段骨折 

分 类 号：R683.42[医药卫生—骨科学] R687.32[医药卫生—外科学]