超关节外固定支架和LCP+MIPPO术式在老年GustiloⅡ型开放性胫骨远端骨折患者中的效果  

Effect of super-articular external fixation and LCP+MIPPO in elderly patients with Gustilo type Ⅱ open distal tibial fracture

作　　者：熊涛 徐坤云 秦凯 余晓丽 XIONG Tao;XU Kun-yun;QIN Kai;YU Xiao-li

机构地区：[1]广信区人民医院骨科,江西上饶334100 [2]衢州市柯城区人民医院急诊科,浙江衢州324000

出　　处：《中国疗养医学》2024年第12期97-100,共4页Chinese Journal of Convalescent Medicine

摘　　要：目的对比分析超关节外固定支架和锁定加压钢板(locking compression plates,LCP)+微创经皮钢板内固定(minimally invasive percutaneous plate osteosynthesis,MIPPO)术式在老年GustiloⅡ型开放性胫骨远端骨折患者中的应用效果差异。方法根据随机数字表将76例于2020年1月至2023年10月在广信区人民医院接受治疗的老年GustiloⅡ型开放性胫骨远端骨折患者分为接受超关节外固定支架治疗的对照组(n=38)和接受LCP+MIPPO术式治疗的研究组(n=38),对两组患者的手术相关指标、患肢血流动力学、踝关节功能及临床疗效进行比较。结果研究组手术、骨折愈合及肿胀消除的时间均低于对照组(P<0.05),术中出血量比较差异无统计学意义(P>0.05);术后1 d,两组足背动脉收缩期峰值血流速度、平均血流速度高于术前,研究组高于对照组(P<0.05),两组足背动脉阻力指数低于术前,研究组低于对照组(P<0.05);术后3个月,两组Baird-Jackson踝关节功能评分表各维度评分高于术前,研究组高于对照组(P<0.05);术后3个月,研究组治疗总有效率为97.37%,高于对照组的78.95%(P<0.05)。结论与超关节外固定支架相比,LCP+MIPPO可缩短老年GustiloⅡ型开放性胫骨远端骨折患者的手术时间,改善术后足背动脉血流动力学,有利于骨折的愈合和踝关节功能的改善,对临床疗效的提高有积极作用。Objective To compare and analyze the application effect difference of super-articular external fixation and locking compression plates(LCP)+minimally invasive percutaneous plate osteosynthesis(MIPPO)in treating elderly patients with Gustilo type Ⅱ open distal tibial fracture.Methods According to the random number table method,76 elderly patients with Gustilo type II open distal tibial fracture treated in Guangxin District People's Hospital from January 2020 to October 2023 were divided into a control group(n=38)receiving super-articular external fixation treatment and a study group(n=38)receiving LCP+MIPPO operation treatment.The surgical indexes,hemodynamics of affected limb,ankle joint function and clinical efficacy of the two groups were compared.Results The time of operation,fracture healing and swelling elimination in the study group was lower than that in the control group(P<0.05),and there was no significant difference in the amount of intraoperative blood loss(P>0.05).On day 1 after surgery,the peak systolic blood flow velocity and average blood flow velocity of dorsalis pedis in both groups were higher than before surgery,and the study group was higher than the control group(P<0.05);the resistance index of dorsalis pedis in both groups was lower than before surgery,and the study group was lower than the control group(P<0.05).Three months after surgery,the scores of Baird-Jackson ankle joint function scale in both groups were higher than those before surgery,and those in the study group were higher than those in the control group(P<0.05).Three months after operation,the total effective rate of the study group was 97.37%,which was higher than that of the control group(78.95%),P<0.05.Conclusion Compared with super-articular external fixation,LCP+MIPPO method can shorten the operative time of elderly patients with Gustilo type Ⅱ open distal tibial fracture,improve postoperative hemodynamics of dorsal foot artery,and contribute to the healing of fracture and improvement of ankle joint function,and have a

关 键 词：超关节外固定支架 锁定加压钢板 微创经皮钢板接骨术 GustiloⅡ型 开放性胫骨远端骨折 

分 类 号：R687.3[医药卫生—骨科学]