改良膝关节撑开器联合微创经皮钢板固定术治疗复杂胫骨平台骨折的疗效  

Efficacy of modified knee spreader combined with minimally invasive percutaneous plate osteosynthesis in treating complex tibial plateau fractures

作　　者：何立锋 柯贤鹏 程宏涛 HE Li-feng;KE Xian-peng;CHENG Hong-tao(Department of Orthopedics,Shangluo Central Hospital,Shangluo 726000,Shaanxi,China)

机构地区：[1]商洛市中心医院骨科,陕西商洛726000

出　　处：《川北医学院学报》2024年第11期1541-1544,共4页Journal of North Sichuan Medical College

基　　金：陕西省商洛市卫生健康委员会(2022C001)。

摘　　要：目的:探讨改良膝关节撑开器联合微创经皮钢板固定术(MIPPO)治疗复杂胫骨平台骨折的疗效。方法:选取102例复杂胫骨平台骨折患者研究对象,按照手术方式不同分为观察组和对照组,每组各51例。观察组患者给予改良膝关节撑开器联合MIPPO;对照组患者给予传统切开复位内固定术,术后随访6个月。比较两组患者临床相关指标(切口长度、住院时间、骨折愈合时间)、术后3 d炎症因子指标[白细胞介素6(IL-6)、白细胞介素8(IL-8)、肿瘤坏死因子α(TNF-α)水平]及氧化应激指标[超氧化物歧化酶(SOD)、皮质醇(COR)、总抗氧化能力(TAC)水平]、术后6个月膝关节功能[美国特种外科医院(HSS)评分]及并发症发生情况。结果:观察组患者切口长度、住院时间、骨折愈合时间低于对照组(P<0.05)。术后3 d,观察组患者IL-6、IL-8、TNF-α、COR水平低于对照组(P<0.05);TAC、SOD水平高于对照组(P<0.05)。术后6个月,观察组患者HSS评分高于对照组(P<0.05);并发症总发生率低于对照组(P<0.05)。结论:相较于传统切开复位内固定术,改良膝关节撑开器联合MIPPO更有助于患者膝关节功能恢复,抑制氧化应激及炎症反应,且并发症发生风险相对较小。Objective:To explore the efficacy of modified knee spreader combined with minimally invasive percutaneous plate osteosynthesis(MIPPO)in treating complex tibial plateau fractures.Methods:The research subjects were 102 patients with complex tibial plateau fractures,and were classified into observation group(MIPPO combined with modified knee spreader,n=51)and control group(traditional open reduction and internal fixation,n=51)according to different surgical methods.They were followed up for 6 months after surgery.The clinical related indicators(incision length,hospital stay,fracture healing time),levels of inflammatory factors[interleukin-6(IL-6),interleukin-8(IL-8),tumor necrosis factor-α(TNF-α)]and oxidative stress indicators[superoxide dismutase(SOD),cortisol(COR),total antioxidant capacity(TAC)]at 3 days after surgery and knee function[Hospital for Special Surgery(HSS)]and occurrence of complications at half a year after surgery were compared between groups.Results:The incision length,hospital stay,and fracture healing time in observation group were lower than those in the control group(P<0.05).At 3 days after surgery,the levels of IL-6,IL-8,TNF-αand COR in observation group were lower than those in the control group(P<0.05),while the levels of TAC and SOD were higher compared to control group(P<0.05).At half a year after surgery,the observation group had higher HSS score(P<0.05)and lower total incidence rate of complications(P<0.05).Conclusion:Compared with traditional open reduction and internal fixation,combined application can better help knee function recovery and inhibit oxidative stress and inflammatory response,and it has relatively small risk of complications.

关 键 词：胫骨 骨折 膝关节 撑开器 MIPPO 炎性因子 氧化应激 

分 类 号：R683[医药卫生—骨科学]