摘要
目的 比较经皮微创内固定（MIPO）与切开复位内固定（ORIF）治疗胫骨干远1/3骨折的疗效.方法 回顾性分析2003年1月至2007年12月采用MIPO和ORIF治疗的58例胫骨干远1/3骨折患者资料,按患者的性别、年龄、骨折的AO分型进行配对,共有15对病例入选.其中男9对,女6对,ORIF组和MIPO组患者平均年龄分别为41.1、39.8岁,受伤至手术时间平均分别为（7.1±4.9）d、（6.5±3.6）d.记录患者的手术时间、术中术后出血总量、骨折愈合时间、恢复工作时间及局部并发症发生情况.应用Johnner-Wruhs胫骨骨折评分系统评价患肢功能,比较两组患者的疗效.结果 ORIF组与MIPO组患者中均无大于5°成角畸形发生.ORIF组7例患者发生并发症.MIPO组11例患者发生并发症,两组比较差异无统计学意义（P=0.136）.Johnner-Wruhs评分：ORIF组优10例,良3例,可1例,差1例;MIPO组优10例,良5例,两组比较差异无统计学意义（P=0.441）.两组患者在手术时间、术中术后出血总量、住院时间、骨折愈合时间及恢复工作时间方面差异均无统计学意义（P〉0.05）.结论 对于胫骨干远1/3骨折的治疗,ORIF与MIPO治疗效果差异不明显.
Objective To compare minimally invasive plate osteosynthesis（MIPO）and open reduction and internal fixation（ORIF）for distal tibia fracture. Methods We retrospectively analyzed 58 patients with distal tibia fracture who had received MIPO or ORIF treatment randomly.We finallv selected 30 （15 pairs of ORIF and MIPO）of them for a pair comparison based on the accordance of sex.age and AO fracture pattern.The average age was respectively 41.1 yrs and 39.8 yrs respectively and the average time interval from initial injury to surgery wag 7.1±4.9 days and 6.5±3.6 days in the either groups.Parameters such as duration of surgery,postoperative drainage volume,healing time,time for return to work,irritative symptoms by internal implants,delayed union,nonunion and infections were recorded.The JohnnerWruhs grading scale was used to evaluate the limb function. Resuits There was no malunion which resulted in angnlation deformity greater than 5°.Only one patient developed osteomyelitis.In ORIF group 10 cases were evaluated as excellent,3 us good,one as fair and one as poor.In MIPO group.10 cages were evaluated as excellent and 5 as good.In the parameters of duration of surgery,postoperative drainage volume and hospital stay,paired ttests found no significant differences between the 2 groups （P values：0.073.0.096 and 0.896）.There were no significant difierences in healing time and time for return to work either（P values：0.737 and 0.379）. Conclusion The MIPO does not manifest distinctively presult than ORIF in treating distal tibia fractures.
出处
《中华创伤骨科杂志》
CAS
CSCD
2010年第7期642-646,共5页
Chinese Journal of Orthopaedic Trauma
关键词
胫骨骨折
骨折固定术
内
外科手术
微创性
Tibial fracture
Fracture fixation,internal
Surgical procedtires,minimally invasive
