MIPPO联合LCP对胫骨Pilon骨折患者损伤关节面复位及踝关节功能恢复情况的影响分析  

Effect of MIPPO combined with LCP on reduction of injured articular surface and recovery of ankle joint function in patients with tibial Pilon fracture

作　　者：周宇[1] 陈凯[1] 季展弘 李明 ZHOU Yu;CHEN Kai;JI Zhan-hong;LI Ming(Department of Trauma and Orthopedics,Liuzhou People's Hospital,Liuzhou 545006,Guangxi;Department of Orthopedics,Xinying Township Health Center,Xiji County,Ningxia,Hui Autonomous region,Xiji 756299,Ningxia,China)

机构地区：[1]柳州市人民医院创伤骨科,广西柳州545006 [2]宁夏西吉县新营乡卫生院骨科,宁夏西吉756299

出　　处：《川北医学院学报》2022年第7期879-882,共4页Journal of North Sichuan Medical College

基　　金：广西壮族自治区柳州市科技计划(2015J030521)。

摘　　要：目的:分析微创经皮接骨板内固定(MIPPO)联合锁定加压钢板(LCP)对胫骨Pilon骨折患者损伤关节面复位及踝关节功能恢复情况的影响。方法:选取102例胫骨Pilon骨折患者为研究对象,根据治疗方式不同分为A组(n=52)和B组(n=50)。A组患者行MIPPO联合LCP内固定术治疗;B组患者行传统切开复位内固定(ORIF)治疗。比较两组患者手术和术后恢复情况、术后6个月踝关节恢复和术后并发症发生情况及手术前、术后两个月血清骨性标志物血清骨钙素(BGP)、Ⅰ型前胶原羧基端肽(PICP)和骨特异性碱性磷酸酶(BAP)水平。结果:A组患者术中失血量较B组少;手术切口长度较B组短;住院时间和骨折愈合时间较B组短,差异均有统计学意义(P<0.05)。术后,A组患者踝关节优良率高于B组(P<0.05)。术前,两组患者BGP、PICP和BAP水平比较,差异无统计学意义(P>0.05);术后,两组患者BGP、PICP和BAP水平均高于手术前(P<0.05),且A组高于B组(P<0.05)。A组患者感染率、钢板松动率、骨折不愈合率低于B组,但差异无统计学意义(P>0.05)。结论:MIPPO联合LCP较ORIF创伤性小,可更好促进胫骨Pilon骨折患者踝关节复位和功能恢复,改善骨代谢状态,缩短骨折愈合时间,值得临床推广。Objective:To analyze the effects of minimally invasive percutaneous bone plate internal fixation(MIPPO) combined with locking compression plate(LCP) on articular surface reduction and ankle functional recovery in patients with tibial Pilon fracture.Methods:102 patients with tibial Pilon fracture were selected as the study subjects.Patients treated with MIPPO combined with LCP internal fixation were included in group A(n=52),and patients treated with traditional open reduction and internal fixation(ORIF) were included in group B(n=50).Operation and postoperative recovery, postoperative ankle joint recovery 6 m after operation, postoperative complications, the levels of serum bone markers serum osteocalcin(BGP),type Ⅰ procollagen carboxy-terminal peptide(PICP) and bone-specific alkaline phosphatase(BAP) before and 2 m after operation were compared between the two groups.Results: Compared with group B,group A had less intraoperative blood loss, shorter incision length, shorter hospital stay and shorter fracture healing time(P<0.05).After operation, the excellent and good rate of ankle joint in group A was higher than that in group B(P<0.05).There was no statistical significance in the levels of BGP,PICP and BAP between the two groups before surgery(P>0.05).After operation, the levels of BGP,PICP and BAP in both groups were higher than before, and the levels of BGP,PICP and BAP in group A were higher than those in group B(P<0.05).The infection rate, plate loosening rate and fracture nonunion rate in group A were lower than those in group B,but there was no difference between the two groups(P>0.05).Conclusion:MIPPO combined with LCP is less traumatic than ORIF,and can significantly promote ankle reduction and functional recovery in patients with tibial Pilon fracture, improve bone metabolism, shorten fracture healing time, with high safety and worthy of promotion.

关 键 词：胫骨PILON骨折 微创经皮接骨板内固定 锁定加压钢板 骨钙素 Ⅰ型前胶原羧基端肽 骨特异性碱性磷酸酶 

分 类 号：R687.3[医药卫生—骨科学]