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中国临床研究:2018,31(9):1228-1231
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微创经皮接骨术与带锁髓内钉术治疗胫骨远端骨折的疗效比较
(晋江市医院骨一科,福建 泉州 362200)
Clinical effect of minimally invasive percutaneous osteosynthesis and intramedullary interlocking nail in the treatment of distal tibial fracture
(First Department of Orthopedic, Jinjiang Municipal Hospital, Quanzhou, Fujian 362200, China)
摘要
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投稿时间:2018-04-15   网络发布日期:2018-09-20
中文摘要: 目的 比较微创经皮接骨术(MIPO)与带锁髓内钉(IIN)术治疗简单型胫骨远端骨折的临床疗效。方法 本研究为单中心的前瞻性随机对照研究,纳入福建省晋江市医院骨科2012年1月至2014年12月60例胫骨远端骨折的患者,随机分为MIPO组(n=30)及IIN组(n=30)。术中主要评估指标包括:手术时间、术中X线透视时间。术后随访应用X线评估骨折愈合时间、畸形愈合、延迟愈合及并发症情况,应用美国足踝外科协会(AOFAS)踝后足评分系统进行功能评估。结果 60例患者均获得随访,随访12~22(18±5)个月。有20例为开放性骨折,MIPO组11例,IIN组9例。MIPO组手术时间59~196(115±46)min,IIN组手术时间42~188(100±37)min,差异无统计学意义(P>0.05)。MIPO组术中X线透视时间为7~81(42±20)s,IIN组为6~54(22±14)s,差异有统计学意义(P<0.01)。MIPO组愈合时间为10~28(17.5±5)周,IIN组为11~26(17.6±4)周,两组差异无统计学意义(P>0.05);两组均未发生畸形愈合,两组均有2例发生延迟愈合。MIPO组2例、IIN组1例发生感染,均使用抗生素治愈。AOFAS评分方面,MIPO组得分为66~98(79.5±9)分,IIN组得分为66~94(80.7±7)分,两组差异无统计学意义(P>0.05)。结论 MIPO技术及IIN技术治疗胫骨远端简单型骨折均能够获得良好地骨折愈合率,均能获得良好的踝关节功能恢复,两种术式均不会增加感染率,也不会影响伤口愈合,两者均为安全、有效的方法。
Abstract:Objective To investigate the clinical effect of minimally invasive percutaneous osteosynthesis (MIPO) and intramedullary interlocking nail (IIN) in the treatment of distal tibial fracture. Methods This study was a single center prospective randomized controlled trial. A total of 60 patients with distal tibial fracture who received treatment at Jinjiang Municipal Hospital was selected and divided into MIPO group and INN group randomly(n=30, each). The main intra-operative indicator included operation time and intra-operative X-ray time. X-ray was used to evaluate the fracture healing time, malformation, delayed union and complications at post-operative follow-up, and the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score was used to assess the function. Results All the 60 patients were followed up for 12-22(18±5) months and there were 20 cases of open fractures (11 cases in MIPO group and 9 cases in INN group). There was no significant difference in operation time between MIPO group and IIN group [59-196(115±46) min vs 42-188(100±37) min, P>0.05]. The intra-operative X-ray time in MIPO group was significant longer than that in INN group [7-81(42±20) s vs 6-54(22±14) s, P<0.01]. There was no significant difference in fracture healing time between MIPO group and IIN group [10-28(17.5±5)weeks vs 11-26(17.6±4)weeks, P>0.05]. There was no malformation in neither group, and there were 2 cases of delayed union in both group. There were 2 cases of infection in MIPO group and 1 case in IIN group, and all of them were cured by antibiotics. There was no significant difference in AOFAS socre between MIPO group and IIN group [66-98(79.5±9) vs 66-94(80.7±7), P>0.05]. Conclusion Both MIPO and IIN is a safe and effective treatment for distal tibial fracture, which could achieve a good fracture healing rate and a well ankle function recovery without increasing infection rate and affecting wound healing.
文章编号:     中图分类号:R 687.3    文献标志码:A
基金项目:福建省晋江市科技计划项目(2012-1-113)
引用文本:
张金山,郑勇强,许永权,施纯南,林振宇,林亮.微创经皮接骨术与带锁髓内钉术治疗胫骨远端骨折的疗效比较[J].中国临床研究,2018,31(9):1228-1231.

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