微创经皮钢板内固定术与切开复位钢板内固定术治疗胫骨PILON骨折疗效比较研究

摘要

目的:对比微创经皮钢板内固定术与切开复位钢板内固定术治疗胫骨PILON骨折的临床疗效.方法:选取2014年11月-2016年1月在我院接受治疗的胫骨PILON骨折患者76例,根据乱数表法将患者分为观察组和对照组各38例.观察组给予微创经皮钢板内固定术,对照组给予切开复位钢板内固定术,对比两组患者手术时间、术后引流量、术后发热时间、术中出血量、骨折愈合时间、住院时间及并发症发生率,对比两组患者术后4、8、12个月膝关节功能评分(HSS)、踝关节功能评分(Baird).结果:观察组手术时间、术后引流量、术后发热时间、术中出血量、骨折愈合时间、住院时间较对照组均显著更少(P＜0.05);观察组术后4、8、12个月HSS评分和Baird评分较对照组显著更高(P＜0.05);观察组总并发症发生率较对照组显著更低(P＜0.05).结论:与切开复位钢板内固定术比较,微刨经皮钢板内固定术能有效减少手术时间、术中出血量、术后引流量、术后发热时间以及住院时间,降低并发症发生率,改善患者术后膝、踝关节功能,加快骨折愈合,促进患者康复,值得临床应用.%Objective:To compare the clinical effect of minimally invasive percutaneous plate osteosynthesis and open reduction plate osteosynthesis for the treatment of tibial PILON fractures.Methods:76 cases with tibial PILON fractures in our hospital from November 2014 to January 2016 were selected.According to therandom number table method,they were divided into observation group and control group as each group 38 cases,the observation group was treated with minimally invasive percutaneous plate osteosynthesis,the control group was treated with open reduction plate osteosynthesis.The operation time,intraoperative blood loss,postoperative drainage volume,postoperative fever time,fracture healing time,length of hospital stay,complication rate of two groups were contrasted.The hospital for special surgery knee score (HSS) and ankle joint function score (Baird) were compared between the two groups at the 4,8 and 12 months after operation.Results:The operation time,intraoperative blood loss,postoperative drainage volume,postoperative fever time,fracture healing time,length of hospital stay of observation group were significantly lower those of the control group (P＜0.05);The HSS score and Baird score of the observation group at 4,8 and 12 months after operation were significantly higher than those in the control group (P＜0.05);The total complication rate of the observation group was significantly lower than that of the control group (P＜0.05).Conclusion:Minimally invasive percutaaeous plate osteosynthesis can effectively reduce the operation time,intraoperative blood loss,postoperative drainage volume,postoperative fever time,length of hospital stay comparison with open reduction plate osteosynthesis,reduce the probability of complications,to improve the function of knee and ankle joint and accelerate the healing of fracture,promote patient recovery,is worthy of clinical application.