微创经皮钢板置入内固定修复胫骨远端骨折的临床疗效及安全性研究

Clinical effect and safety of minimally invasive percutaneous steel plate implantation and internal fixation for repairing distal tibial fractures

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摘要目的探究微创经皮钢板置入内固定修复胫骨远端骨折的临床疗效及安全性。方法选择32183部队医院2017年12月—2018年12月收治的胫骨远端骨折患者67例作为研究对象。按照治疗方法不同分为两组,予以常规切开复位内固定治疗的31例患者作为对照组,予以经皮微创经皮内固定治疗的36例患者作为观察组。对比两组患者的手术时间、出血量、住院时间、骨折愈合时间、胫骨功能恢复等临床疗效和安全性指标。结果观察组所需手术时间(47.17±2.80)min,小于对照组所需时间(66.40±4.90)min,差异有统计学意义(t=6.740,P=0.006)。观察组术中出血量(89.60±6.10)ml,小于对照组术中出血量(234.60±4.90)ml,差异有统计学意义(t=5.620,P=0.001)。观察组骨折愈合周期(10.90±1.50)周,短于对照组骨折愈合周期(15.10±2.10)周,差异有统计学意义(t=2.120,P=0.004)。观察组术后并发症发生率(11.11%)小于对照组(35.48%),差异有统计学意义(x2=5.695,P=0.017)。观察组术后肢体功能恢复优良率(91.67%)大于对照组(70.97%),差异有统计学意义(x2=4.854,P=0.028)。结论微创经皮钢板置入内固定修复胫骨远端骨折的临床疗效显著,安全性高,值得推广。 Objective To explore the clinical effect and safety of minimally invasive percutaneous plate placement and internal fixation to repair distal tibial fractures.Methods A total of 67 patients with distal tibial fractures admitted to the 32183 Army Hospital from December 2017 to December 2018 were selected as the research subjects.According to the different treatment methods,the patients were divided into two groups:31 patients who were treated with conventional open reduction and internal fixation as the control group and 36 patients who were treated with minimally invasive percutaneous internal fixation as the observation group.The operative time,bleeding volume,hospitalization time,fracture healing time and tibial function recovery were compared between the two groups.Results The operation time of the observation group was longer(47.17±2.80)min than that of the control group(66.40±4.90)min,the difference was statistically significant(t=6.740,P=0.006).The amount of intraoperative hemorrhage in the observation group was(89.60±6.10)ml,lower than that in the control group(234.60±4.90)ml,and the difference was statistically significant(t=5.620,P=0.001).The fracture healing period of the observation group was(10.90±1.50)weeks,shorter than that of the control group(15.10±2.10)with statistical significance(t=2.120,P=0.004).The incidence of postoperative complications in the observation group(11.11%)was lower than that in the control group(35.48%),and the difference was statistically significant(x2=5.695,P=0.017).The excellent and good rate of limb function recovery in the observation group(91.67%)was higher than that in the control group(70.97%),and the difference was statistically significant(x2=4.854,P=0.028).Conclusion Minimally invasive percutaneous plate insertion and internal fixation for the repair of distal tibial fractures has significant clinical results and high safety,and is worthy of promotion.