| 外固定支架术后行经皮钢板内固定在胫骨干开放性骨折患者中应用价值的回顾性分析 |
|
Hits: 28
Download times: 2
Received:November 05, 2024
|
| 作者 | Author | 单位 | Unit | E-Mail |
| 蔡鹏飞 |
CAI Peng-fei |
金华市中心医院创伤骨科, 浙江 金华 321000 |
Department of Trauma Orthopaedics, Jinhua Central Hospital, Jinhua 321000, Zhejiang, China |
kewu409@163.com |
| 赵巍 |
ZHAO Wei |
金华市中心医院创伤骨科, 浙江 金华 321000 |
Department of Trauma Orthopaedics, Jinhua Central Hospital, Jinhua 321000, Zhejiang, China |
|
| 王金华 |
WANG Jin-hua |
金华市中心医院创伤骨科, 浙江 金华 321000 |
Department of Trauma Orthopaedics, Jinhua Central Hospital, Jinhua 321000, Zhejiang, China |
|
| 陈仁盛 |
CHEN Ren-sheng |
金华市中心医院创伤骨科, 浙江 金华 321000 |
Department of Trauma Orthopaedics, Jinhua Central Hospital, Jinhua 321000, Zhejiang, China |
|
| 李晓飞 |
LI Xiao-fei |
金华市中心医院创伤骨科, 浙江 金华 321000 |
Department of Trauma Orthopaedics, Jinhua Central Hospital, Jinhua 321000, Zhejiang, China |
|
|
| 期刊信息：《中国骨伤》2025年38卷，第3期，第273-279页 |
| DOI：10.12200/j.issn.1003-0034.20230810 |
| 基金项目:浙江省基础公益研究计划项目(编号:LQ20H060011) |
|
目的: 比较外固定支架术和外固定支架术后行微创经皮钢板内固定(minimally invasive percutaneous plate osteosynthesis,MIPPO)治疗胫骨干开放性骨折的临床疗效。
方法: 自2020年1月至2022年6月收治行外固定支架术治疗的胫骨干开放性骨折患者151例,根据手术方式不同分为外固定组和联合组。外固定组81例,男48例,女33例;年龄21~68(42.58±7.44)岁;Gustilo分型Ⅱ型49例,ⅢA型32例;伤后至就诊时间2.5~10(4.25±0.74) h;行外固定支架术。联合组70例,男42例,女28例;年龄20~69(41.39±7.02)岁;Gustilo分型Ⅱ型35例,ⅢA型35例;伤后至就诊时间3~9(4.31±0.85) h;行外固定支架术后行MIPPO治疗。比较两组骨痂形成时间、骨折愈合时间和并发症情况,并于术后6个月采用Rasmussen评分、美国特种外科医院(Hospital for Special Surgery,HSS)评分评价膝关节功能恢复情况。
结果: 两组患者均获得随访,时间6~13(10.17±2.33)个月。联合组骨痂形成时间、骨折愈合时间分别为(13.98±4.02) d、(70.26±12.15) d,优于外固定组(18.56±4.37)、(79.87±15.41) d,差异有统计学意义(P<0.05)。术后6个月,联合组Rasmussen、HSS评分为(26.79±3.11)、(83.36±9.44)分,高于外固定组(24.51±4.63)、(79.63±8.46)分,差异有统计学意义(P<0.05)。外固定组切口感染、钉道感染各2例,支架松动、骨折移位、延迟愈合、畸形愈合各1例;联合组生物相容性反应1例;两组比较差异有统计学意义(P<0.05)。
结论: 胫骨干开放性骨折患者中外固定支架术后行MIPPO可加快骨痂形成及骨折愈合,改善膝关节功能,提高临床疗效,减少并发症。 |
| [关键词]:胫骨干开放性骨折 外固定支架术 经皮钢板内固定 膝关节功能 病例对照研究 |
| |
| Retrospective analysis of application value of percutaneous plate internal fixation after external fixation stenting in patients with open fracture of tibial shaft |
|
Abstract:
Objective To compare clinical effects of external fixation and minimally invasive percutaneous plate osteosynthesis (MIPPO) after external fixation in treating open fractures of tibial shaft.
Methods From January 2020 to June 2022,151 patients with open fracture of tibial shaft treated with external fixation stenting were divided into external fixation group and combined group according to different surgical methods. There were 81 patients in external fixation group,including 48 males and 33 females,aged from 21 to 68 years old with an average of (42.58±7.44) years old;according to Gustilo classification,49 patients with typeⅡ,32 patients with type ⅢA;the time from injury to treatment ranged from 2.5 to 10 h with an average of (4.25±0.74) h;external fixed stenting was performed. There were 70 patients in combined group,including 42 males and 28 females,aged from 20 to 69 years old with an average of (41.39±7.02) years old;35 patients with type Ⅱ and 35 patients with type ⅢA according to Gustilo classification;the time from injury to treatment ranged from 3 to 9 h with an average of (4.31±0.85) h;MIPPO treatment was performed after external fixed stenting. The time of callus formation,fracture healing and complications were compared between two groups. Rasmussen score and Hospital for Special Surgery (HSS) score were used to evaluate functional recovery of knee joint at 6 months after operation.
Results Both groups were followed up for 6 to 13 months with an average of (10.17±2.33) months. The time of callus formation and fracture healing were (13.98±4.02) d and (70.26±12.15) d in combined group,and (18.56±4.37) d and (79.87±15.41) d in external fixation group,respectively. Combined group was better than external fixation group in the time of callus formation and fracture healing (P<0.05). At six months after operation,Rasmussen and HSS scores in combined group were (26.79±3.11) and (83.36±9.44),which were higher than those in external fixation group (24.51±4.63) and (79.63±8.46) (P<0.05). In external fixation group,there were 2 patients with incision infection,2 patients with nail tract infection,1 patient with stent loosening,fracture displacement,delayed union and malunion,and 1 patient with biocompatibility reaction in combined group,with statistical significance between two groups (P<0.05).
Conclusion MIPPO could accelerate callus formation and fracture healing,improve knee function,improve clinical effects and reduce complications in patients with open tibial shaft fractures after external and external fixation. |
| KEYWORDS:Open fracture of tibial shaft External fixed stenting Percutaneous steel plate internal fixation Knee joint function Case-control study |
| |
| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 蔡鹏飞,赵巍,王金华,陈仁盛,李晓飞.外固定支架术后行经皮钢板内固定在胫骨干开放性骨折患者中应用价值的回顾性分析[J].中国骨伤,2025,38(3):273~279 |
| 英文格式: | CAI Peng-fei,ZHAO Wei,WANG Jin-hua,CHEN Ren-sheng,LI Xiao-fei.Retrospective analysis of application value of percutaneous plate internal fixation after external fixation stenting in patients with open fracture of tibial shaft[J].zhongguo gu shang / China J Orthop Trauma ,2025,38(3):273~279 |
|
| View Full Text View/Add Comment Download reader |
| Close |
|
|
|
