内侧微创经皮锁定钢板和交锁髓内针治疗胫骨远端关节外骨折的疗效比较  

Comparison of minimally invasive percutaneous plate osteosynthesis and intramedullary nail in treating distal extra-articular tibial fracture

作　　者：吕鹏飞[1] 裴征 刘家帮[1] 张清华[1] LYU Peng-fei;PEI Zheng;LIU Jia-bang;ZHANG Qing-hua(Peking University Shougang Hospital,Beijing,100144,China)

机构地区：[1]北京大学首钢医院骨科,100144

出　　处：《中国骨与关节杂志》2021年第8期614-617,共4页Chinese Journal of Bone and Joint

摘　　要：目的比较内侧微创经皮锁定钢板(minimally invasive percutaneous plate osteosythesis,MIPPO)和交锁髓内针(interlocking intramedullary nails,IMN)治疗胫骨远端关节外骨折的手术时间、骨折愈合时间及踝关节功能评分。方法回顾性研究2008年11月至2018年11月,在我院进行手术治疗的胫骨远端骨折患者,所有骨折均未累及胫骨远端关节面,共42例。其中18例采用胫骨远端MIPPO治疗,24例采用IMN治疗,根据两组患者的手术时间、骨折愈合时间、Olerud-Molander踝关节功能评分评价其疗效。结果随访时间10~20个月,平均12个月,所有患者均获得骨性愈合,MIPPO组的平均手术时间(142.9±35.7) min,骨折平均愈合时间(18.8±4.2)周,Olerud-Molander踝关节功能评分(84.44±6.80)分,IMN组的平均手术时间(138.7±37.1) min,骨折平均愈合时间(19.5±2.3)周,Olerud-Molander踝关节功能评分(82.71±5.30)分,两组间差异无统计学意义(P=0.713;P=0.479;P=0.360)。结论使用两种手术方式治疗胫骨远端关节外骨折均可达到较为满意的临床效果,临床实践中,可根据患者的具体情况选择合适的内固定方式。Objective To compare the clinical effects of minimally invasive percutaneous plate osteosynthesis (MIPPO) and intramedullary nail (IMN) in the treatment of distal extra-articular tibial fracture.Methods A retrospective study of 42 patients with distal extra-articular tibial fracture was conducted from November 2008 to November 2018.MIPPO was applied in 18 patients,while IMN in 24 patients.The mean operation time,fracture union time and Olerud-Molander Ankle Score were compared between the two groups.Results Follow-up ranged from 10 months to 20 months (average:12 months).Bone healing was achieved in all patients.MIPPO group:the mean operation time (142.9±35.7) minutes,union time (18.8±4.2) weeks,Olerud-Molander Ankle Score (84.44±6.80);IMN group:the mean operation time (138.7±37.1) minutes,union time (19.5±2.3) weeks,Olerud-Molander Ankle Score (82.71±5.30);no statistical significance was observed between the two groups (P=0.713,P=0.479,P=0.360).Conclusions Both MIPPO and IMN are safe and effective in the treatment of distal extra-articular tibial fracture.Individualized internal fixation is recommended in clinical practice.

关 键 词：胫骨骨折 微创经皮钢板接骨术 交锁髓内针 

分 类 号：R683.4[医药卫生—骨科学] R687.3[医药卫生—外科学]