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投稿时间：2018-04-24 网络发布日期：2018-09-20
投稿时间：2018-04-24 网络发布日期：2018-09-20
中文摘要: 目的 观察膝关节内骨折患者行微创接骨板内固定术（MIPO）后骨折愈合情况及功能恢复效果。方法 将安徽省第二人民医院2014年2月至2015年12月接诊的51例膝关节内骨折患者分成微创组25例,开放对照组26例。微创组行MIPO,对照组行切开复位接骨板内固定术(ORIF),术后两组均随访6～24个月。观察两组患者术后骨痂形成时间、骨折临床愈合时间、骨性愈合时间及膝关节活动度,评价膝关节功能及临床疗效,观察术后恢复过程中感染、血肿等不良反应发生情况。结果 术后,微创组骨痂出现时间、骨折临床愈合时间及骨性愈合时间［(6.04±0.38)周、(9.87±1.12)周、(10.08±1.26)周］均显著短于对照组［(8.11±0.49)周、(11.94±1.65)周、(12.61±1.74)周,P<0.01］；微创组美国特种外科医院膝关节功能评分（HSS）显著高于对照组(87.52±3.68 vs 83.45±3.57,P<0.01),膝关节活动度显著大于对照组［(127.68±9.14)° vs (115.87±7.92)°,P<0.01］;术后,微创组膝关节功能优良率显著高于对照组(92.00% vs 61.54%,P<0.05),并发症发生率显著低于对照组(4.00% vs 30.77%,P<0.05)。结论 MIPO治疗膝关节内骨折患者,术后患者在骨折愈合及膝关节功能恢复方面均有显著优势,并能减少并发症发生。
中文关键词: 膝关节内骨折 内固定术 切开复位；微创接骨板；骨折愈合 膝关节功能恢复
Abstract:Objective To observe the fracture healing situation and the efficacy of functional recovery of intra-articular knee fracture after minimally invasive plate osteosynthesis(MIPO). Methods Fifty-one patients with intra-articular knee fracture received from February 2014 to December 2015 in Anhui No.2 Provincial People's Hospital were divided into minimally invasive treatment group (MIPO group，n=25) and open reduction control group (ORIF group, n=26). MIPO was performed in MIPO group, and open reduction and plate internal fixation (ORIF) was performed in ORIF group. The patients in two groups were followed up for 6 to 24 months after operation. Postoperative callus forming time, fracture clinical healing time, bone healing time, range of motion (ROM) of knee joint after operation were observed in two groups. Knee joint function and clinical efficacy were evaluated. The adverse reactions such as infection, hematoma and so on in the process of postoperative recovery were observed. Results The time of callus occurrence, fracture clinical healing time and bone healing time after operation in MIPO group were significantly shorter than those in ORIF group[(6.04±0.38)weeks vs (8.11±0.49) weeks, (9.87±1.12)weeks vs (11.94±1.65)weeks, (10.08±1.26)weeks vs (12.61±1.74)weeks, all P<0.01]. The knee joint score for HSS in MIPO group was significantly higher than that in ORIF group(87.52±3.68 vs 83.45±3.57, P<0.05). ROM of knee joint after operation in minimally invasive treatment group was significantly larger than that in ORIF control group [(127.68±9.14)° vs (115.87±7.92)°, P<0.01]. The excellent and good rate of knee joint functions after operation in MIPO group was significantly higher than that in ORIF group (92.00% vs 61.54%, P<0.05). The incidence of postoperative complications in MIPO group was significantly lower than that in ORIF group (4.00% vs 30.77%, P<0.05). Conclusion MIPO has significant advantages in fracture healing and knee joint function recovery for the treatment of intra-articular knee fracture and can reduce the occurrence of complications.
keywords: Intra-articular knee fracture Osteosynthesis Minimally invasive plate Open reduction Fracture healing Functional recovery of knee joint
文章编号： 中图分类号：R 683.42 文献标志码：B
基金项目:安徽省自然科学基金(1408084MH136)
附件
| Author Name | Affiliation |
| LIU Wen-xiang, YU Run-ze, ZHANG Biao | Department of Orthopedics, Anhui No.2 Provincial People's Hospital, Hefei, Anhui 230000, China |
引用文本：
刘文祥,余润泽,张彪.微创接骨板内固定术治疗膝关节内骨折的疗效观察[J].中国临床研究,2018,31(9):1236-1239.
刘文祥,余润泽,张彪.微创接骨板内固定术治疗膝关节内骨折的疗效观察[J].中国临床研究,2018,31(9):1236-1239.