摘要
目的对比“微笑切口”联合间接复位技术与传统切开复位内固定(ORIF)技术,系统评估该创新手术方法在患者功能恢复速度及术后美容效果方面的优势。方法选取2022年10月至2024年8月间60例锁骨中段骨折患者,分为对照组(ORIF组,30例)和观察组(MIPPO组,30例)。对照组采用开放复位重建钢板内固定,观察组则应用MIPPO结合间接复位技术和“微笑切口”。评估指标涵盖手术创伤、功能恢复及美容效果。结果MIPPO组在术中出血量[(32.9±7.6)mL vs.(90.2±14.0)mL,P<0.05]、切口长度[(3.0±0.5)cm vs.(8.5±1.2)cm,P<0.05]及手术时间等方面均显著优于ORIF组。功能恢复方面,MIPPO组骨痂形成时间[(10.1±1.7)周vs.(12.8±2.0)周,P<0.05]、初步及完全生活自理时间、负重时间均明显缩短。Constant-Murley评分MIPPO组为91.5±5.1,显著高于ORIF组的82.4±6.0(P<0.05)。美容效果上,MIPPO组SBSES评分高达9.2±0.4,远高于ORIF组的3.0±0.7(P<0.05),其他美容指标如瘢痕显著度、色素沉着指数、瘢痕厚度等亦显著优于ORIF组。结论本研究提出的“微笑切口”联合间接复位技术可显著减少手术创伤、加速术后恢复,并在美容效果上显著优于传统方法,尤其适合对外观要求较高的患者。
Objective To compare the smile incision combined with indirect reduction technique with traditional ORIF technique and systematically evaluate the advantages of this innovative surgical method in terms of functional recovery and postoperative cosmetic effects.Methods A total of 60 patients with midshaft clavicle fractures were enrolled between October 2022 and August 2024.The patients were randomly assigned to either ORIF group(open reduction and internal fixation,n=30)or MIPPO group(MIPPO combined with smile incision,n=30).Outcomes assessed included surgical trauma,functional recovery,and cosmetic outcomes.Results The MIPPO group exhibited significantly reduced intraoperative blood loss[(32.9±7.6)mL vs.(90.2±14.0)mL,P<0.05],shorter incision length[(3.0±0.5)cm vs.(8.5±1.2)cm,P<0.05],and reduced operative time compared to the ORIF group.Functional recovery indicators such as bone healing time[(10.1±1.7)weeks vs.(12.8±2.0)weeks,P<0.05],initial and complete self-care time,and weight-bearing recovery were all significantly improved in the MIPPO group.The Constant-Murley score was higher in the MIPPO group(91.5±5.1 vs.82.4±6.0,P<0.05).Cosmetic outcomes also favored the MIPPO group,with a superior SBSES score(9.2±0.4 vs.3.0±0.7,P<0.05)and better results in scar visibility,pigmentation,thickness,and elasticity.Conclusion The smile incision combined with indirect reduction technique significantly reduces surgical trauma,accelerates postoperative recovery,and provides substantially better cosmetic outcomes compared to conventional methods,making it particularly suitable for patients with high aesthetic expectations.
作者
屈立安
赵晓明
李萌
姬文晨
刘凯
张银刚
QU Li’an;ZHAO Xiaoming;LI Meng;JI Wenchen;LIU Kai;ZHANG Yingang(Department of Orthopedics,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,China)
出处
《西安交通大学学报(医学版)》
北大核心
2025年第3期511-516,共6页
Journal of Xi’an Jiaotong University(Medical Sciences)
基金
陕西省重点研发项目资助(No.2023-YBSF-341)。
