MIPPO结合LCP内固定术在胫骨干骺端骨折中的治疗价值

摘要/Abstract

摘要： 目的：探讨微创经皮钢板内固定（MIPPO）技术结合锁定加压接骨板（LCP）内固定术在胫骨干骺端骨折中的治疗价值。方法：纳入我院2018年8月至2022年8月收治的胫骨干骺端骨折患者70例，按随机数字表法分成微创组与对照组，每组各35例。微创组患者在C臂机引导下采用MIPPO技术结合LCP内固定术治疗，对照组患者行传统切开复位普通钢板固定术。比较两组患者治疗效果及术中出血量、手术时间、骨痂生成时间、骨折愈合时间、住院时间。分别在术前及术后3、6个月，采用美国特种外科医院膝关节评分系统（HSS）评估两组患者的运动功能。分别在术前及术后1个月，采血检测两组患者血清N-端骨钙素（N-MID）、骨碱性磷酸酶（BALP）、Ⅰ型前胶原羧基端肽（PICP）水平，观察两组患者并发症发生情况。结果：微创组患者术后恢复优占比（71.43%）高于对照组（45.71%）（P<0.05）。微创组患者骨痂生成时间、骨折愈合时间较对照组均缩短，术中出血量低于对照组（P<0.05）。两组患者术后3、6个月的HSS评分均高于术前，且微创组患者升高幅度高于对照组（P<0.05）。两组患者术后1个月的血清N-MID、BALP、PICP水平均高于术前，且微创组患者各指标水平升高幅度均高于对照组（P<0.05）。微创组患者并发症发生率（5.71%）低于对照组（22.86%，P<0.05）。结论：C臂机引导下MIPPO技术结合LCP内固定术能缩短胫骨干骺端骨折患者的骨痂形成与愈合时间，促进运动功能恢复，改善骨代谢水平，控制并发症风险。

关键词: 微创经皮钢板内固定术, 锁定加压接骨板, 胫骨干骺端骨折, 骨代谢, 并发症

Abstract: Objective： To investigate the therapeutic effect of minimally invasive percutaneous plate osteosynthesis(MIPPO) combined with locking compression plate (LCP) internal fixation in the treatment of tibial metaphyseal fractures. Methods： A total of 70 patients with tibial metaphyseal fracture admitted in our hospital from August 2018 to August 2022 were included and divided into the minimally invasive group and the control group with 35 patients in each group according to random number table method. The minimally invasive group was treated with MIPPO combined with LCP internal fixation under the guidance of C-arm machine， and the control group was treated with traditional open reduction common plate fixation. The treatment effect， intraoperative blood loss， operation duration， callus formation time， fracture healing time and hospital stay time were compared between the two groups. The Hospital for Special Surgery Knee Scoring System (HSS) was used to evaluate the motor function of the patients before surgery and at 3 and 6 months after surgery. The serum levels of N-terminal mid-fragment (N-MID)， bone alkaline phosphatase (BALP)， carboxy terminal propeptide of type Ⅰ procollagen (PICP)， of pationts in the two groups were detected before operation and one month after operation， and the complications of the two groups were observed. Results： The proportion of optimal recovery in minimally invasive group (71.43%) was higher than that in the control group (45.71%) (P<0.05). The callus formation time and fracture healing time of patients in the minimally invasive group were shorter than those in the control group， and the amount of intraoperative blood loss was lower than that in the control group (P<0.05). The HSS score 3 and 6 months after surgery was higher than that before surgery， and the HSS score of the minimally invasive group patients was higher than that of the control group (P<0.05). The serum level of N-MID， BALP and PICP 1 month after surgery were higher than those before surgery， and those in the minimally invasive group were higher than those in the control group (P<0.05). The complication rate in the minimally invasive group (5.71%) was lower than that in control group (22.86%) (P<0.05). Conclusion： C-arm machine guided MIPPO technique combined with LCP internal fixation can shorten the callus formation time and healing time， promote the recovery of motor function， improve the level of bone metabolism， and control the risk of complications in patients with tibial metaphyseal fracture.

Key words: Minimally invasive percutaneous plate osteosynthesis, Locking compression plate, Tibial metaphyseal fractures, Bone metabolism, Complications

中图分类号:

R687.3

雷博艺, 周百刚. MIPPO结合LCP内固定术在胫骨干骺端骨折中的治疗价值[J]. 中国医药导刊, 2023, 25(12): 1275-1279.

LEI Boyi, ZHOU Baigang. Therapeutic Effect of MIPPO Combined with LCP Internal Fixation in the Treatment of Tibial Metaphyseal Fractures[J]. CHINESE JOURNAL OF MEDICINAL GUIDE, 2023, 25(12): 1275-1279.

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