丁思明+黄焕强++向伟明

    [摘要] 目的 探讨切开复位内固定术(ORIF)及闭合复位微创经皮锁定钢板置入固定术(MIPPO)治疗胫骨骨折的效果。 方法 选择重庆市梁平县第二人民医院2012年1月～2013年1月收治的胫骨远端骨折患者84例，根据手术方式不同分为采用ORIF手术治疗的ORIF组和采用MIPPO手术治疗的MIPPO组，每组各42例。比较两组手术持续时间、住院时间、骨折愈合时间、相关并发症发生率；采用美国骨科协会足踝外科分会(AOFAS)标准，对患者术后踝关节的功能进行测评，并比较两组愈合的优良率。 结果 ①两组患者骨折愈合时间比较差异无统计学意义(P > 0.05)，MIPPO组手术时间[(72.3±13.7)min]及住院时间[(9.1±0.6)d]显著短于ORIF组[(92.7±22.5)min、(19.4±2.7)d]，差异有高度统计学意义(P < 0.01)。②两组优良率及并发症发生率比较差异均无统计学意义(P > 0.05)。 结论 根据骨折类型及软组织条件等，恰当地选择手术时机，基层医院可采用MIPPO技术对胫骨远端骨折进行治疗。

    [关键词] 胫骨远端骨折；闭合复位微创经皮锁定钢板置入固定；切开复位内固定；疗效

    [中图分类号] R683.42[文献标识码] A[文章编号] 1673-7210(2014)05(a)-0027-03

    Efficacy comparison of open reduction with internal fixation and minimally invasive percutaneous plate osteosynthesis in treatment of tibial fracture

    DING Siming HUANG Huanqiang▲ XIANG Weiming

    Department of Orthopaedics, the Second People's Hospital of Liangping County, Chongqing 405212, China

    [Abstract] Objective To discuss the efficacy comparison of open reduction with internal fixation (ORIF) and minimally invasive percutaneous plate osteosynthesis (MIPPO) in the treatment of tibial fracture. Methods 84 cases of distal tibial fracture in the Second People's Hospital of Liangping County from January 2012 to January 2013 were selected and divided into ORIF group and MIPPO group with 42 cases in each group; patients in ORIF group were treated with ORIF, patients in MIPPO group were treated with MIPPO. Operation duration time, hospital stays, fracture healing time, occurrence rate of complication between the two groups were compared. AOFAS standard was used to evaluate the function of the ankle after surgery, and the good healing rate was compared in the two groups. Results ①The differences of fracture healing time between the two groups was not statistically significant (P > 0.05); the operation duration time, hospital stays in MIPPO group [(72.3±13.7) min, (9.1±0.6) d] were shorter than those in ORIF group [(92.7±22.5) min, (19.4±2.7) d], the differences were statistically significant (P < 0.01). ②The differences of good healing rate and complication occurrence rate between the two groups were not statistically significant (P > 0.05). Conclusion With the correct fracture type, soft tissue condition and operation opportunity, the primary hospital can use the MIPPO to treat the distal tibial fracture. ......