CAJ | 학술논문

背景：近年来微创经皮钢板置入内固定技术已成为修复下肢骨折尤其是下肢复杂型骨折一种可选择的方法，其优势就在于可减少对软组织的损伤，不破坏骨质的营养供应血管。但目前对于修复胫骨远端骨折采用何种方法仍没有统一标准。目的：对比观察微创经皮钢板置入内固定和切开复位钢板置入内固定修复胫骨远端骨折的临床效果。方法：纳入60例胫骨远端骨折的病例，其中35例接受微创经皮钢板置入内固定治疗，25例患者接受切开复位钢板置入内固定治疗。通过对软组织进行评分来确定明确的手术时间，术中注意对骨折处软组织的保护并选择合理的方式进行内固定。内固定后指导患者积极的进行早期功能锻炼。临床随访，定期进行X射线复查。通过观察手术时间、患肢负重时间、骨折愈合时间、胫骨功能恢复等指标对比两种内固定方式的临床疗效。结果与结论：所有患者内固定后均得到随访，随访时间3-15个月。微创经皮钢板置入内固定组在治疗 A 型骨折的愈合时间方面与切开复位钢板置入内固定组没有明显差异，B、C型骨折愈合时间优于后者。提示应用微创经皮钢板置入内固定修复胫骨骨折，尤其是胫骨远端复杂型骨折，是一种有效的治疗方法。骨折愈合率高，术后并发症少。
배경：근년래미창경피강판치입내고정기술이성위수복하지골절우기시하지복잡형골절일충가선택적방법，기우세취재우가감소대연조직적손상，불파배골질적영양공응혈관。단목전대우수복경골원단골절채용하충방법잉몰유통일표준。목적：대비관찰미창경피강판치입내고정화절개복위강판치입내고정수복경골원단골절적림상효과。방법：납입60례경골원단골절적병례，기중35례접수미창경피강판치입내고정치료，25례환자접수절개복위강판치입내고정치료。통과대연조직진행평분래학정명학적수술시간，술중주의대골절처연조직적보호병선택합리적방식진행내고정。내고정후지도환자적겁적진행조기공능단련。림상수방，정기진행X사선복사。통과관찰수술시간、환지부중시간、골절유합시간、경골공능회복등지표대비량충내고정방식적림상료효。결과여결론：소유환자내고정후균득도수방，수방시간3-15개월。미창경피강판치입내고정조재치료 A 형골절적유합시간방면여절개복위강판치입내고정조몰유명현차이，B、C형골절유합시간우우후자。제시응용미창경피강판치입내고정수복경골골절，우기시경골원단복잡형골절，시일충유효적치료방법。골절유합솔고，술후병발증소。
BACKGROUND:In recent years, minimal y invasive percutaneous plate fixation has been a selectable method to repair fracture of lower limbs, especial y complex fracture of lower limbs. Its advantages are to reduce the damage to soft tissues, and do not destroy bone nutrient supply vessels. However, there is no unified criterion to select which method in the repair of distal tibial fractures. OBJECTIVE:To observe clinical effects of minimal y invasive percutaneous plate fixation versus open reduction and plate fixation in the repair of distal tibial fractures. METHODS:A total of 60 cases of distal tibial fractures treated with minimal y invasive percutaneous plate osteosynthesis (n=35) and open reduction and plate fixation (n=25) were selected. The time of surgery was identified by evaluating soft tissue. We should pay attention to the protection of soft tissue in surgery and reasonable fixation method should be selected. After fixation, we guided patients to do active early functional exercise. They were fol owed up and regularly received X-ray reexamination. Operation time, weight loading time, healing time and functional recovery were observed and the clinical therapeutic effects of the two methods were compared. RESULTS AND CONCLUSION:Al patients were fol owed-up after surgery. They were fol owed up for 3 to 15 months. No significant difference in healing time of type A fracture was detected between minimal y invasive percutaneous plate fixation and open reduction and plate fixation. The healing time of types B and C fracture was better in minimal y invasive percutaneous plate fixation group than in open reduction and plate fixation group. These results indicated that minimal y invasive percutaneous plate fixation in repair of tibial fractures, especial y distal complex tibial fractures, is an effective method. The healing rate of fracture was high, but postoperative complications were less.