摘要
目的:评价两种不同方法治疗胫骨远端骨折的临床适应证、并发症及其疗效。方法:45例闭合性胫骨远端骨折采用不同手术方法:A组25例,男18例,女7例;按AO/ASIF分类:A型4例,B型14例,C型7例;采用切开复位解剖型钢板内固定。B组20例,男12例,女8例;A型5例,B型9例,C型6例;采用微创经皮锁定钢板内固定。术后观察患者疼痛程度、切口皮肤坏死、深部感染发生率等并发症以及骨折愈合时间、踝关节运动功能进行对比研究。结果:患者术后随访10～15个月,平均12个月。按视觉模拟量表(VAS)评分:A组中度～重度,B组轻度～中度;骨性愈合时间:A组平均(16.0±4.2)周,B组平均(13.0±3.2)周,差异有统计学意义(P<0.01)。A组术后并发症发生率高于B组(P<0.05)。踝关节功能评定按照Kofoed评分标准,术后踝关节功能恢复B组总体优良率明显高于A组(P<0.05)。结论:微创经皮锁定钢板内固定较切开复位解剖型钢板内固定治疗胫骨远端骨折具有手术创伤小,对骨骼血供影响小,骨折愈合快,并发症少,踝关节功能恢复好的优点,符合生物力学内固定。
Objective ： Evaluation of two different methods of treatment of distal tibial fractures of the clinical indications, complications and efficacy. Methods ： Forty-five cases of closed distal tibial fractures were assigned to two groups, 25 cases in group A included 18 males and 7 females ,according to the AO/ASIF classification：4 cases of type A, 14 cases of B ,7 cases of C ,open reduction and anatomic plate fixation were used. Twenty cases in group B included 12 males and 8 females,5 of type A, 9 of B, 6 of C, minimally invasive pereutaneous locking compression plate osteosynthesis were used. Observed on the postoperative pain, skin necrosis of the incision, the incidence of deep infection and other complications, as well as the healing of fractures, ankle motor function for comparative study. Results：All patients were followed up 10 to 15 months, according to the visual analogue scale （VAS） score, group A were moderate to severe in, group B were mild to moderate between. Bone healing time： group A averaged （16.0±4.2） weeks, group B averaged （13.0±3.2） weeks, the difference was significant （P〈0.01）. Postoperative complications of group A was more than that of group B （P〈0.05） ,there were significant differences. Ankle function in accordance with the assessment criteria Kofoed, the good and excellent rate of group B was higher than that of group A （P〈 0.05 ）, there were significant differences. Conclusion ： Minimally invasive percutaneous locking compression plate osteosynthesis compared open reduction and anatomic plate fixation for distal tibial fractures with less trauma surgery, bone blood supply to the affected small, fracture healing faster, less complications, and ankle function better advantage of. It is consistent with the biomechanics of internal fixation, and is the treatment of tibial fractures ideal method.
出处
《中国骨伤》
CAS
2009年第5期361-363,共3页
China Journal of Orthopaedics and Traumatology
关键词
胫骨远端骨折
骨折固定术
MIPPO技术
Distal fractures of tibia
Fracture fixation
Minimally invasive percutaneous plate osteosynthesis （MIPPO）
