两种急诊微创手术治疗A1型胫骨中下段骨折的疗效比较  

Comparison of the efficacy of two kinds of emergency minimally invasive surgery for the treatment of type A1 middle and lower tibial fractures

作　　者：陈旭冯 冯世波[1] CHEN Xufeng;FENG Shibo(Department of Orthopaedics,Wuhan Hankou Hospital,Wuhan 430014,Hubei,China)

机构地区：[1]武汉市汉口医院骨科,湖北武汉4300141

出　　处：《中国现代医生》2024年第7期63-66,共4页China Modern Doctor

摘　　要：目的比较急诊行交锁髓内钉内固定术与微创经皮钢板固定术(mininally invasive percutaneous plate osteosynthesis,MIPPO)治疗Al型胫骨中下段骨折的临床疗效。方法选取2017年1月至2020年12月于武汉市汉口医院治疗的58例A1型胫骨中下段骨折患者为研究对象,根据手术方法不同,将纳入患者分为髓内钉组(n=30)和MIPPO组(n=28)。比较两组患者的手术时间、术中出血量、术中透视次数、切口长度、切口感染率、术后完全负重时间、骨折愈合时间和疗效。结果髓内钉组患者的手术时间长于MIPPO组,术中出血量、透视次数均多于MIPPO组(P<0.05)。髓内钉组患者的完全负重时间显著短于MIPPO组(P<0.05)。两组患者的切口长度、骨折临床愈合时间、切口感染率、优良率比较差异均无统计学意义(P>0.05)。结论MIPPO具有手术时间短、出血量少、透视次数少等优势,交锁髓内钉术后完全负重时间更早,有利于患者的康复锻炼,但二者在治疗A1型胫骨中下段骨折的远期疗效方面并无差别。Objective To compare the clinical efficacy of emergency interlocking intramedullary nail fixation and mininally invasive percutaneous plate osteosynthesis(MIPPO)in treatment of type A1 middle and lower tibial fractures.Methods Fifty-eight patients with type Al middle and lower tibial fractures treated in Wuhan Hankou Hospital from January 2017 to December 2020 were selected as study objects.According to different surgical methods,the included patients were divided into intramedullary nail group(n=30)and MIPPO group(n=28).The operative time,intraoperative blood loss,intraoperative fluoroscopy number,incision length,incision infection rate,postoperative complete weight-bearing time,fracture healing time,and curative effect were compared between two groups.Results The operative time of patients in intramedullary nail group was longer than that in MIPPO group,and intraoperative blood loss and fluoroscopy number were more than those in MIPPO group(P<0.05).The complete weight-bearing time in intramedullary nail group was significantly shorter than that in MIPPO group(P<0.05).There was no significant difference in incision length,clinical healing time,incision infection rate and excellent rate between two groups(P>0.05).Conclusion MIPPO has the advantages of short operation time,less blood loss and less fluoroscopy times,and the complete weight-bearing time after interlocking intramedullary napping is earlier,which is conducive to the rehabilitation and exercise of patients.But there is no difference in the long-term efficacy of the two methods in treatment of type A1 middle and lower tibial fractures.

关 键 词：髓内钉 微创经皮钢板固定术 胫骨骨折 

分 类 号：R683.42[医药卫生—骨科学]