微创经皮钢板联合锁定加压钢板固定术治疗胫骨干骺端骨折的临床疗效

目的:探讨微创经皮钢板固定技术(MIPPO)与锁定加压钢板(LCP)治疗胫骨干骺端骨折的临床疗效。方法:选择2013年6月-2015年6月在我院接受手术治疗的胫骨干骺端骨折患者103例作为研究对象,根据手术方法不同将所选患者分为三组。其中,联合手术组(35例)患者采用MIPPO联合LCP内固定术治疗,外固定组(33例)患者采用超关节外固定支架术治疗,内固定术组(35例)患者采用切开复位钢板内固定术治疗。观察并比较三种手术方法的临床效果及对患者骨关节功能的影响。结果:与外固定术组及内固定术组比较,联合手术组患者的手术时间短,术中出血量少,骨折愈合时间早,差异具有统计学意义(P0.05);联合手术组患者的手术优良率高于外固定组和内固定组,差异有统计学意义(P0.05);内固定组手术优良率高于外固定组,差异具有统计学意义(P0.05);联合手术组患者术后并发症的发生率低于外固定组及内固定组,差异具有统计学意义(P0.05);外固定组与内固定组术后并发症的发生率比较,差异无统计学意义(P0.05)。结论:MIPPO联合LCP内固定治疗胫骨干骺端骨折具有手术切口小、术中出血量少、术后并发症发生率低、骨折愈合快、关节功能恢复较好等优点,是治疗胫骨干骺端骨折的理想方法,值得临床推广应用。

Clinical Effects of MIPPO and LCP on the Treatment of Tibiofibular Fractures

Objective:To investigate the clinical efficacy of minimally invasive percutaneous plate osteosynthesis (MIPPO) and locking compression plate (LCP) on the treatment of tibial metaphyseal fractures.Methods:103 cases with tibial metaphyseal fractures who were treated in our hospital from June 2013 to June 2015 were selected and according to the different treatment methods, the patients were divided into three groups. 35 cases in the combined surgery group were treated with MIPPOand LCP internal fixation, 33 cases in the external fixation group were treated with over articular external fixation, and another 35 cases in the internal fixation group were treated with open reduction and plate fixation. Then the clinical effects and the influence on the bone joint function of the three treatment methods were observed and compared.Results:Compared with the external fixation group and the internal fixation group, the operation time of the combined surgery group was shorter, the blood loss was less, the healing time of fracture was earlier, and the differences were statistically significant (P<0.05); The excellent rate of combined surgery group was significantly higher than those of the external fixation group and the internal fixation group, and the difference was statistically significant (P<0.05); The excellent rate of the internal fixation group was higher than that of the external fixation group, and the difference was statistically significant (P<0.05); The incidence of the postoperative complications in the combined surgery group was lower than those of the external fixation group and the internal fixation group, and the difference was statistically significant (P<0.05); There was no statistically significant difference about the incidence of postoperative complications between the external fixation group and the internal fixation group (P>0.05).Conclusion:The MIPPO and LCP internal fixation on the treatment of tibial stem metaphyseal fractures is worth of clinical application with small incision, less blood loss, lower rate of postoperative complications, and better recovery of fracture healing and joint function.