| 尚锦梁,孙森淼.交锁髓内钉内固定与经皮微创接骨板内固定治疗胫骨远端骨折疗效对比[J].中国烧伤创疡杂志,2024,(2):148~151. |
| DOI： |
| 中文关键词: 交锁髓内钉 经皮微创接骨板 内固定 胫骨远端骨折 膝关节功能 踝关节功能 术后并发症 |
| 英文关键词:Interlocking intramedullary nail Minimally invasive percutaneous plate osteosynthesis Fixation Distal tibial fractures Knee joint function Ankle joint function Postoperative complications |
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| 中文摘要: |
| 【摘要】 目的 对比分析交锁髓内钉 (IIN) 内固定与经皮微创接骨板内固定 (MIPPO) 治疗胫骨远端骨折的临床疗效。 方法 选取 2018 年 12 月至 2020 年 12 月济源市第二人民医院收治的 58 例胫骨远端骨折患者作为研究对象, 根据不同治疗方式将其分为 IIN 组 (28 例) 和 MIPPO 组 (30 例), IIN 组患者采用 IIN 内固定治疗,MIPPO 组患者采用 MIPPO 治疗, 对比观察两组患者手术相关情况、骨折愈合情况、膝关节功能、踝关节功能及术后并发症发生情况。结果 IIN 组患者术中出血量、手术时间及骨折愈合时间与 MIPPO 组均无明显差异 ( t =0.268、1.161、0.309, P= 0.790、0.251、0.759); 术后 3 个月, IIN 组患者膝关节功能及踝关节功能评分与MIPPO 组均无明显差异 (t = 0.406、0.586, P= 0.687、0.561); IIN 组患者术后 1 年感染、延迟愈合发生情况与MIPPO组均无明显差异 ( χ2 = 0.301、0.003, P = 0.583、0.960), 而畸形愈合与关节疼痛发生例数均明显多于MIPPO 组 (χ2 = 4.469、4.870, P= 0.034、0.027)。 结论 IIN 内固定与 MIPPO 治疗胫骨远端骨折的术中出血量?手术时间及骨折愈合时间均无明显差异, 且均能够有效促进膝关节功能及踝关节功能恢复, 但 MIPPO 术后骨折畸形愈合和关节疼痛发生率均明显低于 IIN 内固定, 更具优势。 |
| 英文摘要: |
| 【Abstract】 Objective To compare the clinical efficacy of interlocking intramedullary nail ( IIN) fixation and minimally invasive percutaneous plate osteosynthesis ( MIPPO) in the treatment of distal tibial fractures. Methods 58 patients with distal tibial fractures, admitted into Jiyuan Second People’s Hospital from December 2018 to December 2020, were enrolled as research subjects and divided into IIN group ( n = 28) and MIPPO group ( n = 30) according to different treatments they received. Patients in the IIN group were treated with IIN fixation, while MIPPO was performed on patients in the MIPPO group. The following items including surgery-related condition, fracture healing condition, knee joint function, ankle joint function, and occurrence of postoperative complications were compared between the two groups. Results No significant differences were observed between the IIN group and the MIPPO group in terms of intraoperative blood loss,operative time, fracture healing time ( t = 0.268, 1.161 and 0.309, P = 0.790, 0.251 and 0.759). Three months after surgery, the function scores of knee joint and ankle joint of patients presented no significant differences between the two groups (t = 0.406 and 0.586, P= 0.687 and 0.561), and no significant differences were observed between the two groups in terms of the occurrences of postoperative infection and delayed healing (χ2 = 0.301 and 0.003, P = 0.583 and 0.960), but the numbers of cases with malunion and joint pain in the IIN group were both significantly more than that in the MIPPO group (χ2 = 4.469 and 4.870, P= 0.034 and 0.027). Conclusion There is no significant difference between IIN fixation and MIPPO in the treatment of distal tibial fractures in terms of intraoperative blood loss, operation time and fracture healing time, and the two approaches both can effectively promote the recovery of knee joint function and ankle joint function, but the incidences of fracture malunion and joint pain after MIPPO are significantly lower than that after IIN fixation, and is more favorable for the treatment of distal tibial fracture. |
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