两种内固定治疗胫骨中下段骨折的疗效比较  

Effect comparison of two kinds of internal fixation for treatment of fracture of middle and lower tibia

作　　者：王晶 赵家安 陈亚影 欧阳海洋 刘洋 WANG Jing;ZHAO Jia-an;CHEN Ya-ying;OU-YANG Hai-yang;LIU Yang(Dept of Orthopaedics,Torch Development Zone Hospital of Zhongshan City,Zhongshan, Guangdong 528437, China)

机构地区：[1]中山火炬开发区医院骨科,广东中山528437

出　　处：《临床骨科杂志》2021年第6期871-875,共5页Journal of Clinical Orthopaedics

摘　　要：目的比较闭合复位交锁髓内钉(IMN)固定与微创经皮钢板内固定技术(MIPPO)治疗66例胫骨中下段骨折的疗效。方法将66例胫骨中下段骨折患者根据治疗方式不同分为IMN组(33例,采用IMN固定治疗)和MIPPO组(33例,采用MIPPO治疗)。比较两组手术情况以及末次随访时的疗效。结果患者均获得随访,时间12~36个月。术中出血量和首次扶拐下地时间IMN组均少(早)于MIPPO组(P<0.05),手术时间IMN组长于MIPPO组(P<0.05),切口长度、住院时间及术后肿胀消退时间两组比较差异均无统计学意义(P>0.05)。术后骨痂形成时间、骨折愈合时间两组比较差异均无统计学意义(P>0.05)。末次随访时疼痛VAS评分、Johner-Wruhs评分优良率两组比较差异均无统计学意义(P>0.05)。两组术后并发症发生率比较差异无统计学意义(P>0.05)。结论MIPPO与IMN固定治疗胫骨中下段骨折均能获得良好的疗效,手术时间IMN固定长于MIPPO,但术中出血量IMN固定少于MIPPO。Objective To compare the effect of closed reduction and fixation with interlocking intramedullary nailing(IMN)and minimally invasive percutaneous plate osteosynthesis(MIPPO)for treatment of middle and lower tibial fracture.Methods The 66 cases of middle and lower tibial fractures were randomly divided into IMN group(using IMN fixation)and MIPPO group(using MIPPO fixation),with 33 cases in each group.The surgical situation and the curative effect at the last follow-up were compared between the two groups.Results All cases were followed up for 12~36 months.The intraoperative blood loss volume and the first loading time assisted with crutch in the IMN group was both less(eralier)than those in the MIPPO group(P<0.05),while the operative time in IMN group was longer than that in the MIPPO group(P<0.05).There were no statistically significant differences in incision length,length of hospital stay and time of postoperative swelling regression between the two groups(P>0.05);and there were no statistically significant differences in callus formation time,fracture healing time.At the last follow-up,VAS and the excellelnt-good rate of Johner-Wruhs score had no differences between two groups(P>0.05).There was no statistically significant difference in the incidence rate of complications between the two groups(P>0.05).Conclusions Both MIPPO and IMN fixation can achieve good efficacy in the treatment of middle and lower tibial fractures.Compared with MIPPO,IMN has longer operation time,less intraoperative blood loss volume.

关 键 词：交锁髓内钉 闭合复位术 微创经皮钢板内固定技术 胫骨中下段骨折 

分 类 号：R683.42[医药卫生—骨科学] R687.3[医药卫生—外科学]