本文已被:浏览 1035次 下载 562次
Received:April 15, 2018 Published Online:September 20, 2018
Received:April 15, 2018 Published Online:September 20, 2018
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。
中文关键词: 胫骨远端骨折 微创 微创经皮接骨术 带锁髓内钉 美国足踝外科协会,踝-后足评分
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.
keywords: Distal tibial fracture Minimally invasive Minimally invasive percutaneous osteosynthesis Intramedullary interlocking nail American Orthopaedic Foot and Ankle Society, ankle-hindfoot score
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)
Author Name | Affiliation |
ZHANG Jin-shan, ZHENG Yong-qiang, XU Yong-quan, SHI Chun-nan, LIN Zhen-yu, LIN Liang | First Department of Orthopedic, Jinjiang Municipal Hospital, Quanzhou, Fujian 362200, China |
Author Name | Affiliation |
ZHANG Jin-shan, ZHENG Yong-qiang, XU Yong-quan, SHI Chun-nan, LIN Zhen-yu, LIN Liang | First Department of Orthopedic, Jinjiang Municipal Hospital, Quanzhou, Fujian 362200, China |
引用文本: