微创经皮接骨板内固定联合锁定加压钢板内固定与传统切开复位内固定治疗胫骨Pilon骨折的效果比较
|
摘要
目的分析微创经皮接骨板内固定(MIPPO)联合锁定加压钢板(LCP)内固定术与传统切开复位内固定(ORIF)技术治疗胫骨Pilon骨折的效果。方法我院就诊的胫骨Pilon骨折患者,其中MIPPO联合LCP内固定术治疗(MIPPO+LCP组)、ORIF治疗(ORIF组)各60例。对比两组手术、损伤关节面复位及踝关节功能恢复情况,并统计并发症发生率。结果两组骨折至手术时间比较差异无统计学意义(P> 0. 05); MIPPO+LCP组住院时间及骨折愈合时间均较ORIF组短,术中失血量低于ORIF组,解剖复位比例、踝关节功能恢复优良率高于ORIF组(P <0. 05),两组并发症发生率比较差异无统计学意义(P> 0. 05)。结论与胫骨Pilon骨折患者,行MIPPO+LCP内固定术治疗或更利于宿舍关节面复位及踝关节功能恢复,值得临床重视。
Objective To analyze the effects of minimally invasive percutaneous plate osteosynthesis( MIPPO) combined with locking compression plate( LCP) internal fixation and conventional open reduction and internal fixation( ORIF) in the treatment of tibial pilon fracture.Methods Sixty patients with tibial pilon fractures treated with MIPPO combined with LCP internal fixation( MIPPO+LCP group) and 60 patients treated with ORIF( ORIF group) in our hospital were enrolled in the study.The conditions of surgery,reduction of the injured articular surface and recovery of ankle function were compared between the two groups.The incidence of complications was also statistically analyzed.Results There was no significant difference in the time from fracture to surgery between the two groups( P > 0. 05).The length of hospital stay and fracture healing time of the MIPPO+LCP group were shorter than those of the ORIF group,and the blood loss during surgery was less than the ORIF group( P < 0. 05).The anatomical reduction rate and the excellent and good rate of ankle function recovery in the MIPPO + LCP group were significantly higher than those in the ORIF group( P < 0. 05).There was no significant difference in the incidence of complications between the two groups( P > 0. 05).Conclusion MIPPO combined with LCP internal fixation is more beneficial to the reduction of articular surface and recovery of ankle joint function in patients with tibial pilon fractures.
Objective To analyze the effects of minimally invasive percutaneous plate osteosynthesis( MIPPO) combined with locking compression plate( LCP) internal fixation and conventional open reduction and internal fixation( ORIF) in the treatment of tibial pilon fracture.Methods Sixty patients with tibial pilon fractures treated with MIPPO combined with LCP internal fixation( MIPPO+LCP group) and 60 patients treated with ORIF( ORIF group) in our hospital were enrolled in the study.The conditions of surgery,reduction of the injured articular surface and recovery of ankle function were compared between the two groups.The incidence of complications was also statistically analyzed.Results There was no significant difference in the time from fracture to surgery between the two groups( P > 0. 05).The length of hospital stay and fracture healing time of the MIPPO+LCP group were shorter than those of the ORIF group,and the blood loss during surgery was less than the ORIF group( P < 0. 05).The anatomical reduction rate and the excellent and good rate of ankle function recovery in the MIPPO + LCP group were significantly higher than those in the ORIF group( P < 0. 05).There was no significant difference in the incidence of complications between the two groups( P > 0. 05).Conclusion MIPPO combined with LCP internal fixation is more beneficial to the reduction of articular surface and recovery of ankle joint function in patients with tibial pilon fractures.
引文
[1]魏世隽,蔡贤华,黄继锋,等.内外翻不同损伤机制导致胫骨Pilon骨折的手术策略[J].中华骨科杂志,2014,34(3):298-305.
[2]王智祥,魏世隽,蔡贤华.胫骨Pilon骨折分型现状[J].中国矫形外科杂志,2018,26(6):533-537.
[3]吴建华.胫骨Pilon骨折采用有限切开锁定钢板内固定治疗的临床效果分析[J].实用医学杂志,2014,30(18):3027-3028.
[4]张志新,周君东,陈兴阳,等.锁定加压接骨板结合微创经皮钢板内固定技术与交锁髓内钉治疗老年性胫骨中下段骨折[J].中国组织工程研究,2017,21(15):2378-2382.
[5]刘名,顾健,王凯,等.经皮微创钢板内固定与传统术式治疗胫骨平台骨折疗效和膝关节功能的比较研究[J].中国现代医学杂志,2017,27(25):79-82.
[6]刘志雄.骨科常用诊断分类方法和功能结果评定标准(精)[M].北京:北京科学技术出版社,2005:187-190.
[7]麦胡强.切开复位胫骨远端解剖钢板内固定术治疗胫骨Pilon骨折的临床效果[J].实用医学杂志,2014,30(14):2256-2257.
[8]李鲲,李静,张坤,等.前后联合入路切开复位内固定治疗RüediAllg(o)werⅢ型pilon骨折[J].中华骨科杂志,2015,35(7):533-537
[9]熊庆广,王永清,张庆杰,等.多向锁定带锁髓内钉治疗胫骨pilon骨折的疗效分析[J].世界最新医学信息文摘,2017,35(a1):720-726.
[10]高洪,施慧鹏,罗从风,等.带关节外固定架在高能量Pilon骨折治疗中的应用[J].中华骨科杂志,2017,26(21):216-219.
[11]陈鹏,田晓滨.切开复位内固定与微创经皮钢板接骨术治疗复杂肱骨近端骨折的疗效比较[J].中华创伤骨科杂志,2016,18(7):592-596.
[12]肖志林,周明昌,冯经旺,等.微创经皮钢板接骨术结合锁定加压钢板与切开复位解剖型钢板内固定治疗胫骨远端骨折的疗效比较[J].中华创伤骨科杂志,2014,16(1):91-92.
[13]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.
[14]杨树,倪江东,宋德业,等.经皮微创与开放复位内固定术治疗胫骨中下段骨折的临床疗效比较[J].中国现代医学杂志,2014,24(23):88-93.
[15]刘斌,王泉,尚红涛.微创经皮钢板固定技术联合锁定加压钢板治疗胫骨干骺端骨折的临床疗效评估[J].中国老年学杂志,2016,36(10):2446-2447.
[16]柴明祥,赵斌,张文武,等.三种固定方法治疗AO分型43-A型胫骨骨折的疗效比较[J].中华创伤骨科杂志,2016,18(7):579-585.
[17]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.
[2]王智祥,魏世隽,蔡贤华.胫骨Pilon骨折分型现状[J].中国矫形外科杂志,2018,26(6):533-537.
[3]吴建华.胫骨Pilon骨折采用有限切开锁定钢板内固定治疗的临床效果分析[J].实用医学杂志,2014,30(18):3027-3028.
[4]张志新,周君东,陈兴阳,等.锁定加压接骨板结合微创经皮钢板内固定技术与交锁髓内钉治疗老年性胫骨中下段骨折[J].中国组织工程研究,2017,21(15):2378-2382.
[5]刘名,顾健,王凯,等.经皮微创钢板内固定与传统术式治疗胫骨平台骨折疗效和膝关节功能的比较研究[J].中国现代医学杂志,2017,27(25):79-82.
[6]刘志雄.骨科常用诊断分类方法和功能结果评定标准(精)[M].北京:北京科学技术出版社,2005:187-190.
[7]麦胡强.切开复位胫骨远端解剖钢板内固定术治疗胫骨Pilon骨折的临床效果[J].实用医学杂志,2014,30(14):2256-2257.
[8]李鲲,李静,张坤,等.前后联合入路切开复位内固定治疗RüediAllg(o)werⅢ型pilon骨折[J].中华骨科杂志,2015,35(7):533-537
[9]熊庆广,王永清,张庆杰,等.多向锁定带锁髓内钉治疗胫骨pilon骨折的疗效分析[J].世界最新医学信息文摘,2017,35(a1):720-726.
[10]高洪,施慧鹏,罗从风,等.带关节外固定架在高能量Pilon骨折治疗中的应用[J].中华骨科杂志,2017,26(21):216-219.
[11]陈鹏,田晓滨.切开复位内固定与微创经皮钢板接骨术治疗复杂肱骨近端骨折的疗效比较[J].中华创伤骨科杂志,2016,18(7):592-596.
[12]肖志林,周明昌,冯经旺,等.微创经皮钢板接骨术结合锁定加压钢板与切开复位解剖型钢板内固定治疗胫骨远端骨折的疗效比较[J].中华创伤骨科杂志,2014,16(1):91-92.
[13]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.
[14]杨树,倪江东,宋德业,等.经皮微创与开放复位内固定术治疗胫骨中下段骨折的临床疗效比较[J].中国现代医学杂志,2014,24(23):88-93.
[15]刘斌,王泉,尚红涛.微创经皮钢板固定技术联合锁定加压钢板治疗胫骨干骺端骨折的临床疗效评估[J].中国老年学杂志,2016,36(10):2446-2447.
[16]柴明祥,赵斌,张文武,等.三种固定方法治疗AO分型43-A型胫骨骨折的疗效比较[J].中华创伤骨科杂志,2016,18(7):579-585.
[17]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.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |