锁定钢板小切口微创内固定术在胫骨远端骨折治疗中的应用
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摘要
目的:探讨锁定钢板小切口微创内固定术在成年人胫骨远端骨折治疗中的应用效果。方法:选取2013年5月-2015年6月在阳春市人民医院骨科进行诊治的60例胫骨远端骨折患者为研究对象,采用随机数字表法将患者分为常规组与试验组,每组30例,其中试验组患者采用锁定钢板小切口微创内固定法(MIPPO)进行治疗,常规组采用钢板内固定(ORIF)治疗,收集两组患者治疗前后的临床信息,比较两组的预后情况。结果:试验组患者的手术出血量、手术耗时、下床活动时间、住院时间及骨折愈合时间均优于常规组,差异均有统计学意义(P<0.05)。试验组术后并发症总发生率为6.67%,明显低于常规组的26.67%,差异有统计学意义(P<0.05)。试验组优良率为96.67%,高于常规组的80.00%,差异有统计学意义(P<0.05)。结论:采取锁定钢板小切口微创内固定术治疗成年人胫骨远端骨折效果满意,较传统方法具有明显的优势,值得在临床中推广使用。
Objective:To explore the treatment effects and safety of minimally invasive percutaneous locking plate osteosynthesis in distal tibial fractures.Method:From May 2013 to June 2015,60 patients with distal tibial fractures treated in People's Hospital of Yangchun City were selected,and divided into experimental group and routine group according to the random number table method,30 patients in each group.The experimental group treated with minimally invasive percutaneous locking plate osteosynthesis(MIPPO),while the routine group were treated with open reduction and internal fixation(ORIF).The clinical information of two groups were selected and their prognosis were compared.Result:The experimental group's bleeding volume,operation time,recover normal activity time,hospital stays,fracture healing time,all were better than those of the routine group,the differences were statistically significant(P<0.05).The rate of postoperative complications in experimental group was 6.67%,which was lower than 26.67% of the routine group,the difference was statistically significant(P<0.05).The excellent and good rate in experimental group was 96.67%,higher than 80.00% in routine group,the difference was statistically significant(P<0.05).Conclusion:Minimally invasive percutaneous locking plate osteosynthesis is obviously effective in the treatment of distal tibial fractures,with the advantages of shorten operation time and hospital stay,reduce bleeding,accelerate bone healing,and decrease the risk of complications,worthy to be clinically promoted.
Objective:To explore the treatment effects and safety of minimally invasive percutaneous locking plate osteosynthesis in distal tibial fractures.Method:From May 2013 to June 2015,60 patients with distal tibial fractures treated in People's Hospital of Yangchun City were selected,and divided into experimental group and routine group according to the random number table method,30 patients in each group.The experimental group treated with minimally invasive percutaneous locking plate osteosynthesis(MIPPO),while the routine group were treated with open reduction and internal fixation(ORIF).The clinical information of two groups were selected and their prognosis were compared.Result:The experimental group's bleeding volume,operation time,recover normal activity time,hospital stays,fracture healing time,all were better than those of the routine group,the differences were statistically significant(P<0.05).The rate of postoperative complications in experimental group was 6.67%,which was lower than 26.67% of the routine group,the difference was statistically significant(P<0.05).The excellent and good rate in experimental group was 96.67%,higher than 80.00% in routine group,the difference was statistically significant(P<0.05).Conclusion:Minimally invasive percutaneous locking plate osteosynthesis is obviously effective in the treatment of distal tibial fractures,with the advantages of shorten operation time and hospital stay,reduce bleeding,accelerate bone healing,and decrease the risk of complications,worthy to be clinically promoted.
引文
[1]杨俊,白杨,聂军,等.锁定钢板在青少年胫骨远端三平面骨折治疗中的应用[J].实用医学杂志,2011,27(24):4473-4475.
[2]Jain S,Harwoed P.Does the use of an intramedullary nai alter the duration of exteral fixation and rate of consolidation in tibial lenhening procedures?A systematic review[J].Strat Traum Linab Recon,2012,7(3):113-121.
[3]Attal R,Hansen M,Kirjavainen M,et al.A muloticentre case series of tibia fractures treated with the Expert Tibia Nail(ENT)[J].Arch Orthop Trauma Surg,2012,132(7):975-984.
[4]Thomas P Rüedi,Richard E Buckley,Christopher G Moran.骨折治疗的AO原则[M].2版.上海:上海科学技术出版社,2010:624-625.
[5]饶汉荣,陈骏钦.经皮微创锁定加压钢板内固定治疗胫骨远端骨折的临床观察[J].辽宁医学院学报,2016,37(2):41-43.
[6]刘强.锁定加压钢板与外固定架治疗胫骨远端骨折的对比分析[J].中国实用医药,2016,11(8):3-5.
[7]江水华,郭开今,陈树祥,等.微创经皮钢板内固定治疗胫骨骨折[J].中华微创外科杂志,2007,7(12):1208.
[8]石岩,王生介,赵金坤,等.微创内固定系统在粉碎性股骨远端骨折中的应用[J].实用骨科杂志,2012,18(3):207-210.
[9]王丛林,樊文中.经皮微创接骨板内固定技术联合锁定加压钢板治疗胫骨远端骨折的疗效分析[J].中外医疗,2015,10(5):82-83.
[10]武政,刘向栋,周煜虎,等.微创经皮锁定加压钢板内固定术治疗胫骨远端骨折疗效观察[J].现代中西医结合杂志,2015,23(7):736-738.
[11]邱新建,方宣城,夏西尚,等.微创钢板内固定联合锁定加压钢板治疗胫骨远端骨折的临床疗效[J].蚌埠医学院学报,2015,20(5):638-640.
[12]唐岩,邢宏,田野,等.锁定钢板内固定治疗胫骨远端骨折[J].中国骨与关节损伤杂志,2011,26(2):181-182.
[13]张浩,申国庆,高发旺,等.MIPPO技术在胫骨远端骨折手术治疗中的应用[J].中国骨与关节损伤杂志,2013,28(4):374-375.
[14]王薪华,孙根发,赵炜,等.微创经皮钢板技术治疗胫骨复杂骨折的临床研究[J].实用骨科杂志,2015,21(1):84-85.
[15]陈细明,蔡树辉,吴育锋,等.手法复位经皮解剖型锁定钢板外固定治疗锁骨骨折[J].中医正骨,2014,26(7):28-29.
[16]王威,陈国富.锁定钢板治疗青少年胫骨远端三平面骨折疗效观察[J].求医问药(学术版),2012,10(9):466.
[17]石晶,魏戎.锁定钢板内固定治疗青少年胫骨远端三平面骨折的临床疗效[J].中国骨与关节损伤杂志,2015,30(12):1280-1282.
[18]丁思明,黄焕强,向伟明,等.胫骨骨折闭合复位经皮置人锁定钢板固定与切开复位钢板内固定的疗效比较[J].中国医药导报,2014,11(13):27-29.
[19]魏涛.微创经皮钢板置入内固定修复胫骨远端骨折的效果及术后并发症分析[J].医药指南,2015,11(33):23-24.
[20]王立强,范萌,刘成刚,等.经皮微创治疗胫骨远端骨折的疗效观察[J].中华医学杂志,2015,95(35):2865-2867.
[21]郝连升,王新昌,陈健,等.微创经皮钢板内固定与切开复位内固定治疗闭合性胫骨远端骨折的对比研究[J].中医正骨,2016,28(10):14-23.
[22]康列和,刘文和.微创经皮钢板内固定治疗胫骨远端骨折[J].中国骨伤,2007,20(7):477-478.
[23]刘显东,王小兵,巫宗德,等.合理运用钢板微创治疗胫骨远端骨折临床观察[J].中国骨伤,2011,24(5):429-430.
[2]Jain S,Harwoed P.Does the use of an intramedullary nai alter the duration of exteral fixation and rate of consolidation in tibial lenhening procedures?A systematic review[J].Strat Traum Linab Recon,2012,7(3):113-121.
[3]Attal R,Hansen M,Kirjavainen M,et al.A muloticentre case series of tibia fractures treated with the Expert Tibia Nail(ENT)[J].Arch Orthop Trauma Surg,2012,132(7):975-984.
[4]Thomas P Rüedi,Richard E Buckley,Christopher G Moran.骨折治疗的AO原则[M].2版.上海:上海科学技术出版社,2010:624-625.
[5]饶汉荣,陈骏钦.经皮微创锁定加压钢板内固定治疗胫骨远端骨折的临床观察[J].辽宁医学院学报,2016,37(2):41-43.
[6]刘强.锁定加压钢板与外固定架治疗胫骨远端骨折的对比分析[J].中国实用医药,2016,11(8):3-5.
[7]江水华,郭开今,陈树祥,等.微创经皮钢板内固定治疗胫骨骨折[J].中华微创外科杂志,2007,7(12):1208.
[8]石岩,王生介,赵金坤,等.微创内固定系统在粉碎性股骨远端骨折中的应用[J].实用骨科杂志,2012,18(3):207-210.
[9]王丛林,樊文中.经皮微创接骨板内固定技术联合锁定加压钢板治疗胫骨远端骨折的疗效分析[J].中外医疗,2015,10(5):82-83.
[10]武政,刘向栋,周煜虎,等.微创经皮锁定加压钢板内固定术治疗胫骨远端骨折疗效观察[J].现代中西医结合杂志,2015,23(7):736-738.
[11]邱新建,方宣城,夏西尚,等.微创钢板内固定联合锁定加压钢板治疗胫骨远端骨折的临床疗效[J].蚌埠医学院学报,2015,20(5):638-640.
[12]唐岩,邢宏,田野,等.锁定钢板内固定治疗胫骨远端骨折[J].中国骨与关节损伤杂志,2011,26(2):181-182.
[13]张浩,申国庆,高发旺,等.MIPPO技术在胫骨远端骨折手术治疗中的应用[J].中国骨与关节损伤杂志,2013,28(4):374-375.
[14]王薪华,孙根发,赵炜,等.微创经皮钢板技术治疗胫骨复杂骨折的临床研究[J].实用骨科杂志,2015,21(1):84-85.
[15]陈细明,蔡树辉,吴育锋,等.手法复位经皮解剖型锁定钢板外固定治疗锁骨骨折[J].中医正骨,2014,26(7):28-29.
[16]王威,陈国富.锁定钢板治疗青少年胫骨远端三平面骨折疗效观察[J].求医问药(学术版),2012,10(9):466.
[17]石晶,魏戎.锁定钢板内固定治疗青少年胫骨远端三平面骨折的临床疗效[J].中国骨与关节损伤杂志,2015,30(12):1280-1282.
[18]丁思明,黄焕强,向伟明,等.胫骨骨折闭合复位经皮置人锁定钢板固定与切开复位钢板内固定的疗效比较[J].中国医药导报,2014,11(13):27-29.
[19]魏涛.微创经皮钢板置入内固定修复胫骨远端骨折的效果及术后并发症分析[J].医药指南,2015,11(33):23-24.
[20]王立强,范萌,刘成刚,等.经皮微创治疗胫骨远端骨折的疗效观察[J].中华医学杂志,2015,95(35):2865-2867.
[21]郝连升,王新昌,陈健,等.微创经皮钢板内固定与切开复位内固定治疗闭合性胫骨远端骨折的对比研究[J].中医正骨,2016,28(10):14-23.
[22]康列和,刘文和.微创经皮钢板内固定治疗胫骨远端骨折[J].中国骨伤,2007,20(7):477-478.
[23]刘显东,王小兵,巫宗德,等.合理运用钢板微创治疗胫骨远端骨折临床观察[J].中国骨伤,2011,24(5):429-430.