张志强

摘 要 目的：探讨经皮微创钢板固定术治疗胫骨骨折的效果。方法：选择单侧胫骨干骨折患者150例作为研究对象，按照治疗方法不同分为观察组和对照组各75例。对照组采用切开复位钢板内固定，观察组采用经皮微创钢板固定术治疗。比较两组手术时间、术中出血量、住院时间、骨折愈合时间、术后疼痛程度、术后并发症、治疗效果情况。结果：两组患者手术时间比较差异不显著（P>0.05）；观察组患者手术术中出血量、住院时间、骨折愈合时间、术后一周疼痛程度、疗效优良率、术后并发症发生率均显著优于对照组（P<0.05）。结论：经皮微创钢板固定术治疗胫骨骨折具有较好效果。

关键词 胫骨骨折 经皮微创钢板固定术 切开复位钢板内固定

中图分类号：R683.42 文献标志码：A 文章编号：1006-1533（2018）21-0056-03

Effect of minimally invasive percutaneous plate fixation in the treatment of 75 cases of tibial shaft fractures

ZHANG Zhiqiang*

（Department of Orthopedics， Zhengzhou Central Hospital affiliated to Zhengzhou University， Zhengzhou 450007， China）

ABSTRACT Objective： To explore the effects of minimally invasive percutaneous plate osteosynthesis on tibial fracture. Methods： One hundred and fifty patients with tibial fracture were selected and divided into an observation group （n=75） and a control group （n=75） based on their different treatment methods. The control group underwent open reduction and internal fixation and the observation group underwent minimally invasive percutaneous plate fixation （MIPPO）. Operation time， blood loss during operation， hospital stays， fracture healing time， pain degree， postoperative complications and clinical effects were compared between the two groups. Results： There were no significant differences in operation time between the two group（P>0.05）. The amount of bleeding， hospital stay， fracture healing time， postoperative pain one week after surgery， excellent and good rate of curative effect and incidence of postoperative complications were significantly much better in the observation group than the control group （P<0.05）. Conclusion： MIPPO fixation for the treatment of tibial fractures is effective.

KEy WORDS tibial fracture； minimally invasive percutaneous plate osteosynthesis； open reduction and internal fixation

脛骨骨折是一种临床常见骨折类型，严重影响患者的生活质量和生活自理能力，且骨折严重时可能对周围的组织和血供产生影响，不利于治疗。传统的开放式手术治疗虽取得一定成效，但存在创伤大、出血量多及在手术过程中可能损伤骨折周围软组织血供等缺点，导致术后骨折延迟愈合及术后并发症多等；不利于患者预后[1-3]。微创钢板内固定术（minimally invasive plate osteosynthesis， MIPO）是一种近年来在四肢长骨骨折治疗中得到广泛应用的治疗方法，该方法避免骨折部位的直接暴露，保留骨折周围的血运，为骨折的愈合提供更加稳定的生物学环境，极大的促进了患者骨折愈合和患者患肢的功能恢复。本研究将微创钢板内固定术应用于胫骨骨折，取得较好疗效。