有限切开联合经皮微创接骨板内固定治疗胫骨远端粉碎性骨折的效果分析  

Effect analysis of limited incision combined with minimally invasive percutaneous plate osteosynthesis in the treatment of distal tibial comminuted fractures

作　　者：王彦[1] WANG Yan(Changzhou Hospital of Traditional Chinese Medicine,Changzhou 213000,China)

机构地区：[1]常州市中医医院,213000

出　　处：《中国现代药物应用》2023年第20期34-37,共4页Chinese Journal of Modern Drug Application

摘　　要：目的比较有限切开联合经皮微创接骨板内固定与前外侧L型锁定钢板内固定治疗胫骨远端粉碎性骨折的临床疗效。方法30例胫骨远端粉碎性骨折患者,随机分为对照组和观察组,各15例。对照组采用前外侧L型锁定钢板内固定治疗,观察组采用有限切开联合经皮微创接骨板内固定治疗。比较两组患者手术相关指标、术后并发症发生情况及美国矫形足踝协会评分系统(AOFAS)评分、视觉模拟评分法(VAS)评分。结果两组骨折愈合时间比较,差异无统计学意义(P>0.05);观察组手术时间(99.67±18.19)min、切口愈合时间(5.47±1.60)d均短于对照组的(137.67±25.29)min、(7.20±2.48)d,术中出血量(94.67±14.53)ml少于对照组的(125.33±22.05)ml,差异具有统计学意义(P<0.05)。术后3个月,观察组AOFAS评分(83.33±5.21)分高于对照组的(76.93±4.51)分,VAS评分(1.47±0.92)分低于对照组的(2.13±0.74)分,差异具有统计学意义(P<0.05);末次随访,两组AOFAS评分和VAS评分比较,差异无统计学意义(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)。结论有限切开联合经皮微创接骨板内固定治疗胫骨远端粉碎性骨折具有创伤小、手术时间短、切口恢复快等优点,对术后早期踝关节功能恢复及缓解术后疼痛均具有明显优势。Objective To compare the clinical efficacy of limited incision combined with minimally invasive percutaneous plate osteosynthesis vs anterolateral L-shaped locking plate in the treatment of distal tibial comminuted fractures.Methods A total of 30 patients with distal tibial comminuted fractures were randomly divided into the control group and the observation group,with 15 cases in each group.The control group was treated with anterolateral L-shaped locking plate,and the observation group was treated with limited incision and minimally invasive percutaneous plate osteosynthesis.The surgical indicators,postoperative complications,American Orthopaedic Foot and Ankle Society(AOFAS)score and visual analogue score(VAS)were compared between the two groups.Results There was no statistically significant difference in fracture healing time between the two groups(P>0.05).The operative time of(99.67±18.19)min and incision healing time of(5.47±1.60)d in the observation group were shorter than those of(137.67±25.29)min and(7.20±2.48)d in the control group;the intraoperative blood loss of(94.67±14.53)ml in the observation group was less than that of(125.33±22.05)ml in the control group;the differences were statistically significant(P<0.05).At 3 months after surgery,AOFAS score of(83.33±5.21)points in the observation group was higher than that of(76.93±4.51)points in the control group,and VAS score of(1.47±0.92)points was lower than that of(2.13±0.74)points in the control group.The differences were statistically significant(P<0.05).At the last follow-up,there was no statistically significant difference in AOFAS score and VAS score between the two groups(P>0.05).Conclusion Limited incision combined with minimally invasive percutaneous plate osteosynthesis has the advantages of less trauma,shorter operative time,faster incision recovery in the treatment of distal tibial comminuted fractures,and has obvious advantages in early postoperative ankle function recovery and pain relief.

关 键 词：有限切开 经皮微创接骨板内固定 胫骨远端粉碎性骨折 踝关节功能 

分 类 号：R687.3[医药卫生—骨科学]