微创内固定系统钢板经皮钢板结合接骨术与切开复位内固定术对胫腓骨骨折病人围术期指标及术后关节功能恢复的影响

doi:10.3969/j.issn.1005-6483.2021.10.018

摘要/Abstract

摘要： 目的研究微创内固定系统(LISS)钢板结合微创经皮钢板接骨术(MIPPO)与切开复位内固定术对胫腓骨骨折病人围术期指标及术后关节功能恢复的影响。
方法 2016年10月～2019年10月胫腓骨骨折病人92例，采用随机数字表法均分为两组，每组各46例，观察组采用LISS钢板结合MIPPO治疗，对照组实施切开复位内固定手术，比较两组围术期指标、应激指标、关节功能和并发症。
结果观察组手术时间、切口大小、术中出血量、住院时间及骨折愈合时间均优于对照组，差异有统计学意义(P<0.05)；两组术后第1天和第7天血清前列腺素E2（PGE2）、皮质醇（Cor）和去甲肾上腺素（NE）水平明显升高，差异有统计学意义(P<0.05)，术后第7天较第1天明显降低(P<0.05)，且观察组术后第1天血清PGE2、Cor和NE水平均低于对照组，差异有统计学意义(P<0.05)；两组术后3个月关节功能优良率分别为82.61%和63.04%(P<0.05)；两组术后12个月时关节功能优良率分别为93.48%和86.96%(P>0.05)；两组并发症发生率分别为13.04%和30.43%(P<0.05)。
结论 LISS钢板结合MIPPO治疗胫腓骨骨折具有明显微创优势，有利于促进骨折愈合和关节功能恢复，同时减少手术并发症。

关键词: 微创内固定系统钢板, 微创经皮钢板接骨术, 胫腓骨骨折, 围术期, 关节功能

Abstract: Objective To study the effects of less invasive stabilization system(LISS) plate combined with minimally invasive percutaneous plate osteosynthesis(MIPPO) technique and open reduction and internal fixation on perioperative indexes and postoperative joint function recovery in patients with tibiofibular fractures.
Methods Totally 92 patients with tibiofibular fractures in our hospital between October 2016 and October 2019 were divided into two groups by random number table method,with 46 cases in each group.Observation group was treated with LISS plate combined with MIPPO technique,and control group was given open reduction and internal fixation.The perioperative indexes,stress indicators,joint function and complications were compared between the two groups.
Results The surgical time,incision size,intraoperative blood loss,hospital stay and fracture healing time in observation group were shorter or less than those in control group(P<0.05).On the 1st d and 7th d after surgery,the levels of serum PGE2,Cor and NE in the two groups were significantly increased(P<0.05),and the levels on the 7th d after surgery were significantly lower than those on the 1st d after surgery(P<0.05),and the levels of serum PGE2,Cor and NE in observation group were lower than those in control group on the 1st d after surgery(P<0.05).The excellent and good rates of joint function in the two groups were 82.61% and 63.04% at 3 months after surgery(P<0.05).The excellent and good rates of joint function in the two groups at 12 months after surgery were 93.48% and 86.96% respectively(P>0.05).The incidence rates of complications were 13.04% and 30.43% in the two groups。respectively(P<0.05).
Conclusion LISS plate combined with MIPPO technique has obvious minimally invasive advantages in the treatment of tibiofibular fractures,and it is beneficial to promote fracture healing and joint function recovery and reduce the surgical complications.

Key words: less invasive stabilizing system plate, minimally invasive percutaneous plate osteosynthesis, tibiofibular fractures, perioperative period, joint function

李林何久盛张浩. 微创内固定系统钢板经皮钢板结合接骨术与切开复位内固定术对胫腓骨骨折病人围术期指标及术后关节功能恢复的影响[J]. 临床外科杂志, 2021, 29(10): 960-963.

LI Lin, HE, Jiusheng, ZHANG Hao.. Effects of minimally invasive LISS plate with MIPPO technique and open reduction and internal fixation on perioperative indexes and postoperative joint function recovery in patients with tibiofibular fractures[J]. JOURNAL OF CLINICAL SURGERY, 2021, 29(10): 960-963.

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