MIPPO术联合LCP内固定治疗胫骨远端骨折的疗效分析
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摘要
目的研究微创经皮钢板接骨术(minimally invasive percutaneous plate osteosynthesis,MIPPO)联合锁定加压钢板(locking compression plate,LCP)内固定治疗胫骨远端骨折的临床效果。方法回顾性分析2013年11月至2017年6月间我院骨科收治的胫骨远端骨折患者,按照治疗方法分为两组,对照组41例给予切开复位克氏针钢板内固定术,观察组45例给予MIPPO术联合LCP内固定治疗,评估两组患者手术时间、术后引流量、住院时间和愈合时间等临床基本指标和Maryland足功能评分,同时比较两组患者术后并发症的发生率。结果观察组总治愈率93. 33%,显著高于对照组75. 61%(P <0. 05),观察组Maryland足功能评分均显著高于对照组(P <0. 05)。观察组患者手术时间、住院时间和愈合时间均显著短于对照组(P <0. 05),观察组患者术后引流量显著少于对照组(P <0. 05),观察组术后并发症总发生率为4. 44%,显著低于对照组的19. 51%(P <0. 05)。结论相比于常规切开复位内固定术,MIPPO术联合LCP内固定治疗胫骨远端骨折能够显著缩短患者骨折愈合时间,改善踝关节运动功能,对降低术后并发症的发生有显著效果,值得临床推广应用。
Objective To study the effect of MIPPO combined with LCP in the treatment of distal radius fractures. Methods Retrospective analysis was carried out in 86 patients with distal tibial fractures treated in our hospital from November 2013 to June 2017. They were divided into two groups according to the treatment methods. 41 cases in the control group was treated with open reduction,kirschner wire and plate fixation,and45 cases in the experimental group was treated with MIPPO combined with LCP internal fixation. The basic clinical indexes such as operation time,postoperative drainage,hospitalization time and healing time were evaluated. Maryland foot function score,the curative effect and motor function were evaluated. At the same time,the incidence of postoperative complications in the two groups was compared during the 6 months' follow-up period. Results After treatments with different methods,the total curative rate of the experimental group was significantly higher than that of the control group( P < 0. 05),and the Maryland foot function score of the experimental group was significantly higher than that of the control group( P < 0. 05). Operation time,hospitalization time and healing time of the experimental group was significantly less than that of the control group,and the drainage volume of the experimental group was significantly less than that of the control group( P < 0. 05).The total incidence of postoperative complications in the experimental group was significantly less than that of the control group( P < 0. 05). Conclusion Compared with conventional open reduction and internal fixation,MIPPO combined with LCP can significantly shorten bone healing time of distal tibial fractures,improve ankle movement functions,and reduce postoperative complications. It is worthy of clinical application.
Objective To study the effect of MIPPO combined with LCP in the treatment of distal radius fractures. Methods Retrospective analysis was carried out in 86 patients with distal tibial fractures treated in our hospital from November 2013 to June 2017. They were divided into two groups according to the treatment methods. 41 cases in the control group was treated with open reduction,kirschner wire and plate fixation,and45 cases in the experimental group was treated with MIPPO combined with LCP internal fixation. The basic clinical indexes such as operation time,postoperative drainage,hospitalization time and healing time were evaluated. Maryland foot function score,the curative effect and motor function were evaluated. At the same time,the incidence of postoperative complications in the two groups was compared during the 6 months' follow-up period. Results After treatments with different methods,the total curative rate of the experimental group was significantly higher than that of the control group( P < 0. 05),and the Maryland foot function score of the experimental group was significantly higher than that of the control group( P < 0. 05). Operation time,hospitalization time and healing time of the experimental group was significantly less than that of the control group,and the drainage volume of the experimental group was significantly less than that of the control group( P < 0. 05).The total incidence of postoperative complications in the experimental group was significantly less than that of the control group( P < 0. 05). Conclusion Compared with conventional open reduction and internal fixation,MIPPO combined with LCP can significantly shorten bone healing time of distal tibial fractures,improve ankle movement functions,and reduce postoperative complications. It is worthy of clinical application.
引文
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[6]Anjum R,Choudhary V,Sharma V.Revisited:A prospective study on functional outcome of internal fixation of tibial pilon fractures with locking plate using MIPO[J].J Clin Diagn Res,2016,10(10):RL01.
[7]徐显春,齐保闯,唐强.两种方法内固定治疗胫骨下段骨折疗效比较[J].临床骨科杂志,2018,21(02):203-205.
[8]张峰炜,钟建华,王震.胫骨中下段闭合性骨折应用微创经皮锁定加压钢板内固定术的临床研究[J].吉林医学,2016,37(9):2199-2201.
[9]van Dreumel RL,van Wunnik BP,Janssen L,et al.Mid-to longterm functional outcome after open reduction and internal fixation of tibial plateau fractures[J].Injury,2015,46(8):1608-1612.
[10]包远祥,苏忠林,刘悦臣,等.胫骨远端骨折患者的手术治疗方案研究[J].中国现代医学杂志,2014,24(22):92-95.
[11]郑联合,王育才,于哲,等.经皮锁定钢板内固定治疗胫骨远端骨折的临床研究[J].中国骨与关节损伤杂志,2012,27(4):353-354.
[2]Siffri PC,Peindl RD,Coley ER,et al.Biomechanical analysis of blade plate versus locking plate fixation for a proximal humerus fracture:comparison using cadaveric and synthetic humeri[J].JOrthop Trauma,2006,20(8):547-554.
[3]刘勇,雷华.微创经皮钢板接骨术结合锁定加压钢板治疗86例胫骨远端骨折的效果研究[J].中国医学工程,2018,26(2):96-98.
[4]Denard A Jr,Richards J E,Obremskey W T,et al.Outcome of nonoperative vs operative treatment of humeral shaft fractures:a retrospective study of 213 patients[J].Orthopedics,2010,33(8):552-552.
[5]石伟哲,肖海军.内侧与外侧经皮微创钢板内固定治疗A型闭合性胫骨远端骨折的疗效比较[J].中国骨与关节损伤杂志,2015,30(06):606-609.
[6]Anjum R,Choudhary V,Sharma V.Revisited:A prospective study on functional outcome of internal fixation of tibial pilon fractures with locking plate using MIPO[J].J Clin Diagn Res,2016,10(10):RL01.
[7]徐显春,齐保闯,唐强.两种方法内固定治疗胫骨下段骨折疗效比较[J].临床骨科杂志,2018,21(02):203-205.
[8]张峰炜,钟建华,王震.胫骨中下段闭合性骨折应用微创经皮锁定加压钢板内固定术的临床研究[J].吉林医学,2016,37(9):2199-2201.
[9]van Dreumel RL,van Wunnik BP,Janssen L,et al.Mid-to longterm functional outcome after open reduction and internal fixation of tibial plateau fractures[J].Injury,2015,46(8):1608-1612.
[10]包远祥,苏忠林,刘悦臣,等.胫骨远端骨折患者的手术治疗方案研究[J].中国现代医学杂志,2014,24(22):92-95.
[11]郑联合,王育才,于哲,等.经皮锁定钢板内固定治疗胫骨远端骨折的临床研究[J].中国骨与关节损伤杂志,2012,27(4):353-354.