曾健聪++++++林卓锋++++++杨云海++++++邓军

[摘要] 目的 比较微创经皮钢板内固定（MIPPO）技术与切开复位钢板内固定（ORIF）治疗胫骨远端骨折的临床效果。 方法 选取本院2012年3月～2014年3月接收治疗的胫骨远端骨折患者120例，在治疗方法上均选取钢板内固定的方式。根据患者就诊日期奇偶数不同将其平均分为ORIF组和MIPPO组，分别给予传统的ORIF技术和MIPPO方法进行治疗，比较两组的疗效。 结果 MIPPO组手术时间、骨折恢复时间短于ORIF组，术中出血量少于ORIF组，差异有统计学意义（P<0.05）。ORIF组手术后恢复期的效果不佳，对患者的健康有一定的影响，MIPPO组并发症发生率明显低于ORIF组，差异有统计学意义（P<0.05）。 结论 MIPPO技术在治疗效果、操作技术、安全实用性等方面都比传统的ORIF方法具有优势，具有临床研究价值和推广应用意义。

[关键词] 胫骨远端骨折；微创经皮钢板内固定；切开复位钢板内固定

[中图分类号] R683.42[文献标识码] A[文章编号] 1674-4721（2014）06（a）-0063-03

Clinical effect comparison of minimally invasive percutaneous plate osteosynthesis and open reduction and internal fixation in the treatment of distal tibial fracture

ZENG Jian-cong LIN Zhuo-feng YANG Yun-hai DENG Jun

Department of Orthopedics,Shiyan People′s Hospital of Baoan District in ShenzhenCity,Shezhen 518108,China

[Abstract] Objective To compare the clinical effect of minimally invasive percutaneous plate osteosynthesis (MIPPO) and open reduction and internal fixation (ORIF) in the treatment of distal tibial fracture. Methods 120 cases of patients with distal tibial fracture treated in our hospital from March 2012 to March 2014 were selected as the study objects,all patients were treated by plates internal fixation,then were divided into ORIF group and MIPPO group,which were treated by ORIF and MIPPO respectively,the clinical efficacy was compared between two groups. Results Operation time,fracture recovery time in MIPPO group was shorter than that in the ORIF group,blood loss was less than that in the ORIF group,the difference was significant (P<0.05).The incidence of complication in ORIF group was lower than that in the ORIF group,the difference was significant (P<0.05). Conclusion The clinical efficacy,operation technique,safety and practicability of MIPPO are better than those of ORIF,which worhty of being studyed and promoted in clinic.

[Key words] Distal tibial fracture;Minimally invasive external fixation;Open reduction with internal fixation

胫骨远端骨折作为临床中发生率较高的骨科疾病，发生部位为踝关节，创伤性因素作为主要的致病原因，并且会出现不同程度的韧带拉伤、肌肉组织受损等身体伤害，这对于患者的身体健康和行为活动都有着严重的影响，及时有效的治疗则是避免问题出现根本解决方法[1]。在治疗方法的选择上一直是医务工作者研究深思的问题，传统的切开复位钢板内固定（open reduction and internal fixation，ORIF）方法在治疗过程中会产生较大的伤害性，针对胫骨远端在解剖学中的特殊位置[2]。本院认为微创经皮钢板内固定（minimally invasive percutaneous plate osteosynthesis，MIPPO）具有更好的作用效果。

1 资料与方法

1.1 一般资料

选取本院2012年3月～2014年3月接收治疗的胫骨远端骨折患者120例，在治疗方法上均选取钢板内固定的方式。根据患者就诊日期奇偶数不同将其平均分为ORIF组和MIPPO组，其中ORIF组男性24例，女性36例；年龄18~63岁，平均（38.5±10.7）岁；患侧发生在左面33例，患侧在右面27例；……