外侧锁定加压钢板内固定术治疗闭合性胫骨下端骨折效果观察

发布时间：2018-01-28 08:29

本文关键词： 胫骨下端骨折闭合性骨折钢板内固定外侧固定内侧固定手术入路　出处：《山东医药》2017年30期 　论文类型：期刊论文

【摘要】：目的观察采用经皮微创钢板内固定(MIPPO)技术行外侧锁定加压钢板内固定术治疗闭合性胫骨下端骨折的临床疗效。方法选择闭合性胫骨下端骨折患者62例,分为A组32例、B组30例。两组均于伤后24~48h内采用MIPPO技术行骨折内固定术治疗。A组行闭合复位胫前内侧锁定加压钢板内固定术,B组行闭合复位胫前外侧锁定加压钢板内固定术。术后6、12周评价骨折愈合情况,参照Olerud-Molander评分系统评价踝关节功能。比较两组手术时间、术中出血量、功能锻炼开始时间、出现骨痂时间、住院时间及术后并发症情况。结果 A组、B组总有效率分别为87.50%(28/32)、96.67%(29/30),B组总有效率高于A组(P0.05)。两组手术时间、术中出血量、功能锻炼开始时间、患肢负重时间、出现骨痂时间、住院时间差异均无统计学意义(P均0.05)。B组术后并发症发生率低于A组(P0.05)。结论外侧锁定加压钢板内固定术治疗闭合性胫骨下端骨折效果较好,且不会增加手术时间、术中出血量、功能锻炼开始时间、患肢负重时间及住院时间,术后并发症少。
[Abstract]:Objective to observe the application of percutaneous minimally invasive plate fixation (MIPPO). Methods 62 cases of closed distal tibial fractures were selected. Group A was divided into group A (n = 32) and group B (n = 30). Both groups were treated with internal fixation of fracture with MIPPO technique within 48 hours after injury. Group A was treated with closed reduction, anterior medial locking compression plate fixation. Group B was treated with closed reduction, anterolateral locking compression plate internal fixation, and fracture healing was evaluated 6 to 12 weeks after operation. According to the Olerud-Molander scoring system, the ankle function was evaluated. The operation time, intraoperative blood loss, the beginning time of functional exercise and the time of callus were compared between the two groups. Results the total effective rates of group A and B were 87.50 / 28 / 32 / 96. 67 / 29 / 30 respectively. The total effective rate in group B was higher than that in group A (P 0.05). The incidence of postoperative complications in group B was lower than that in group A (P < 0.05). Conclusion Lateral locking compression plate internal fixation is effective in the treatment of closed distal tibial fractures. The operative time, the amount of blood lost during operation, the start time of functional exercise, the time of loading weight of the affected limb and the time of hospitalization were not increased, and the postoperative complications were less.
【作者单位】：东阿县中医医院;东阿县人民医院;
【分类号】：R687.3
【正文快照】： 胫骨下端骨折是临床常见的骨折类型,占四肢骨折的33%左右[1]。由于胫骨下端内侧的皮肤、肌肉等软组织覆盖较少,容易遭受到直接暴力损伤而导致骨折,也导致此处血运供应受损;手术内固定时如过多剥离骨膜,有可能损伤残留的血供,导致骨折不愈合、骨折迟延愈合等并发症。因此,术中

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