小切口插入闭合复位经皮微创钢板内固定术治疗胫腓骨骨折患者的效果  

Effects of small incision insertion closed reduction and percutaneous minimally invasive plate internal fixation in treatment of patients with tibiofibular fractures

作　　者：李明 邱学文 曾磊 LI Ming;QIU Xuewen;ZENG Lei(Orthopedics Department of Jiangxi Jiayou Shuguang Orthopaedic Hospital,Nanchang 330000 Jiangxi,China)

机构地区：[1]江西嘉佑曙光骨科医院骨科,江西南昌330000

出　　处：《中国民康医学》2025年第2期49-51,共3页Medical Journal of Chinese People’s Health

摘　　要：目的:观察小切口插入闭合复位经皮微创钢板内固定术(MIPPO)治疗胫腓骨骨折患者的效果。方法:选取2021年8月至2023年8月该院收治的94例胫腓骨骨折患者进行前瞻性研究,按随机数字表法将其分为对照组与观察组各47例。对照组行切开复位钢板内固定术(ORIF)治疗,观察组行MIPPO治疗。比较两组围术期指标水平,手术前后应激指标[皮质醇(Cor)、去甲肾上腺素(NE)]水平、踝关节功能[美国足踝外科学协会踝-后足评分(AOFAS-AH)]评分、膝关节功能[美国特种外科医院膝关节(HSS)]评分,以及并发症发生率。结果:观察组术中出血量少于对照组,早期自主活动时间、完全负重时间、住院时间均短于对照组,差异有统计学意义(P<0.05);术后3 d,两组Cor、NE水平均高于术前,但观察组低于对照组,差异有统计学意义(P<0.05);术后3个月,两组AOFAS-AH、HSS评分均高于术前,且观察组高于对照组,差异有统计学意义(P<0.05);观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:MIPPO治疗胫腓骨骨折患者可提高踝关节功能和膝关节功能评分,降低应激指标水平、并发症发生率,改善围术期指标水平,其效果优于ORIF治疗。Objective:To observe effects of small incision insertion closed reduction and percutaneous minimally invasive plate internal fixation(MIPPO)in treatment of patients with tibiofibular fractures.Methods:A prospective study was conducted on 94 patients with tibiofibular fractures admitted to our hospital from August 2021 to August 2023.According to the random number table method,they were divided into control group and observation group,47 cases in each group.The control group was treated with open reduction and plate internal fixation(ORIF),while the observation group was treated with MIPPO.The levels of perioperative indicators and stress indicators[cortisol(Cor),norepinephrine(NE)],the ankle function[American Orthopaedic Foot and Ankle Society ankle-hindfoot(AOFAS-AH)]score,the knee function[hospital for special surgery-knee(HSS)]score before and after the surgery,and the incidence of complications were compared between the two groups.Results:The intraoperative blood loss in the observation group was less than that in the control group;the early spontaneous activity time,the full weight-bearing time and the hospitalization time were shorter than those in the control group,and the differences were statistically significant(P<0.05).3 days after the surgery,the levels of Cor and NE in the two groups were higher than those before the surgery,but those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).3 months after the surgery,the scores of AOFAS-AH and HSS in the two groups were higher than those before the surgery,those in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).Further,the incidence of complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusions:MIPPO in the treatment of the patients with tibiofibular fractures can improve the ankle function and knee function scores,reduce

关 键 词：胫腓骨骨折 小切口插入闭合复位经皮微创钢板内固定术 切开复位钢板内固定术 踝关节功能 膝关节功能 应激反应 并发症 

分 类 号：R683.42[医药卫生—骨科学]