微创经皮钢板固定术治疗胫骨中下段骨折的疗效分析  

Efficacy of Minimally Invasive Percutaneous Plate Osteosynthesis in Treating Fractures in the Middle and Lower Segments of the Tibia

作　　者：周骁阳 贾俊杰 周云烽 段鹏 石义华 ZHOU Xiao-yang;JIA Jun-jie;ZHOU Yun-feng;DUAN Peng;SHI Yi-hua(Department of Orthopedics,Xiangyang No.1 People′s Hospital,Hubei Universi-ty of Medicine,Xiangyang,Hubei 441000,China;Department of Obstetrics and Gynecology,Xiangyang No.1 People′s Hospital,Hubei Universi-ty of Medicine,Xiangyang,Hubei 441000,China)

机构地区：[1]湖北医药学院附属襄阳市第一人民医院骨科,湖北十堰442000 [2]湖北医药学院附属襄阳市第一人民医院妇产科,湖北十堰442000

出　　处：《湖北医药学院学报》2024年第4期396-400,共5页Journal of Hubei University of Medicine

基　　金：湖北省重点研发计划项目(2022CFD010);湖北省卫生健康委面上项目(WJ2023M162);湖北省“323”攻坚行动重点专项科研基金(XYY2022-323);襄阳市科技局重点项目(2022YL24A)。

摘　　要：目的:比较交锁髓内钉内固定术(interlocking intramedullary nailing,IMN)和微创经皮钢板固定术(mini⁃mally invasive percutaneous plate osteosynthesis,MIPPO)治疗胫骨中下段骨折的手术效果。方法:2020年1月-2022年12月我院收治的胫骨中下段骨折患者66例,分为对照组和观察组,每组33例。观察组实施MIPPO治疗,对照组实施IMN治疗,对两组患者的手术情况、治疗效果以及C反应蛋白(CRP)、血沉和白细胞计数等指标进行比较。结果:观察组术中出血量、住院时间、骨折愈合时间均少于对照组,差异有统计学意义(P<0.05)。观察组Johner-Wruhs评分优良率(93.9%)显著高于对照组(75.8%)(P<0.05)。两组患者治疗后CRP、血沉及白细胞计数均较治疗前升高,观察组升高水平较对照组低(P<0.05)。结论:对于胫骨中下段骨折,MIPPO的临床治疗效果优于IMN,可作为首选治疗方式。Objective To compare the efficacy of intramedullary nailing(IMN)and minimally invasive percutaneous plate osteosynthesis(MIPPO)in the treatment of fractures in the middle and lower segments of the tibia.Methods A total of 66 patients with fractures in the middle and lower segments of the tibia treated in the Xiangyang No.1 People′s Hospital,Hubei University of Medicine from January 2020 to December 2022 were selected and divided into a control group and an observa⁃tion group,with 33 in each group.The observation group underwent MIPPO,while the control group received IMN.Surgi⁃cal outcomes,therapeutic effects,C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),and white blood cell(WBC)count were compared between the two groups.Results The observation group had lower intraoperative blood loss,shorter hospital stays,and faster fracture healing than the control group(P<0.05).The excellent and good results of Johner-Wruhs scoring system in the observation group was 93.9%,which was higher than the 75.8%in the control group(P<0.05).Furthermore,CRP,ESR,and WBC count were elevated in both groups after treatment,but the control group showed higher increases compared with the observation group(P<0.05).Conclusion For fractures in the middle and lower seg⁃ments of the tibia,MIPPO demonstrates superior clinical outcomes to IMN and should be considered as the preferred treat⁃ment method.

关 键 词：胫骨中下段骨折 微创经皮钢板固定术 交锁髓内钉内固定术 

分 类 号：R687.3[医药卫生—骨科学]