CAJ | 학술논문

目的：比较经皮微创钢板固定技术（ MIPPO）和外固定支架固定术治疗Gustilo II型胫腓骨骨折的疗效。方法选择65例Gustilo II型胫腓骨骨折患者，根据手术方式不同分为MIPPO组（33例）和外固定支架组（32例）。比较2组手术时间、术中出血量、肿胀消退时间、骨折愈合时间，评价优良率及术后并发症发生情况。结果MIPPO组与外固定支架组术中出血量、肿胀消退时间比较无明显差异（ P ＞0 s．05），而MIPPO组较外固定支架组手术时间短，差异有统计学意义（ P ＜0．05），术后骨折愈合时间，MIPPO组较外固定支架组明显缩短（ P ＜0．05）。术后并发症发生率2组比较差异无统计学意义（21．2％vs．21．9％， P ＞0．05），但MIPPO组中发生感染例数相对较多。末次随访MIPPO组优良率亦明显优于外固定支架（90．9％vs．78．1％， P ＜0．05）。结论经皮微创钢板固定技术和外固定支架固定术治疗Gustilo II型胫腓骨骨折均有良好的临床疗效。经皮微创钢板固定技术手术时间短，骨折愈合相对快，远期疗效佳，而外固定支架治疗感染的发生率低。
목적：비교경피미창강판고정기술（ MIPPO）화외고정지가고정술치료Gustilo II형경비골골절적료효。방법선택65례Gustilo II형경비골골절환자，근거수술방식불동분위MIPPO조（33례）화외고정지가조（32례）。비교2조수술시간、술중출혈량、종창소퇴시간、골절유합시간，평개우량솔급술후병발증발생정황。결과MIPPO조여외고정지가조술중출혈량、종창소퇴시간비교무명현차이（ P ＞0 s．05），이MIPPO조교외고정지가조수술시간단，차이유통계학의의（ P ＜0．05），술후골절유합시간，MIPPO조교외고정지가조명현축단（ P ＜0．05）。술후병발증발생솔2조비교차이무통계학의의（21．2％vs．21．9％， P ＞0．05），단MIPPO조중발생감염례수상대교다。말차수방MIPPO조우량솔역명현우우외고정지가（90．9％vs．78．1％， P ＜0．05）。결론경피미창강판고정기술화외고정지가고정술치료Gustilo II형경비골골절균유량호적림상료효。경피미창강판고정기술수술시간단，골절유합상대쾌，원기료효가，이외고정지가치료감염적발생솔저。
Objective To compare the effect of minimally invasive percutaneous plate osteosynthesis ( MIPPO) and external fixation technique in the treatment of Gustilo type II fractures of tibia and fibula .Methods Sixty-five cases of Gustilo type II fractures of tibia and fibula patients were enrolled , according to the operation mode , they were divided into MIPPO group (33 cases) and external fixator group (32 cases).The operation time, bleeding volume, postoperative 2 groups swel-ling subsided time , healing time of fracture , the excellent and good rate and postoperative complications were compared be-tween the two groups .Results The amount of bleeding , swelling time showed no significant difference between the MIPPO group and external fixation group ( P >0.05), MIPPO group’s operation time is shorter than the external fixator group , the difference was statistically significant ( P <0.05), postoperative fracture healing time in MIPPO group was significantly shor-tened compared with the external fixator group ( P <0.05).The incidence of postoperative complications has no significant difference (21.2% vs.21.9%, P >0.05) between the 2 groups, but the minimally invasive percutaneous plate fixation group has relatively more cases of infection .The last time follow-up showed that minimally invasive percutaneous plate fixation group’s excellent and good rate was also significantly more than external fixator group (90.9%vs.78.1%, P <0.05).Con-clusion Both minimally invasive percutaneous plate fixation and external fixation for the treatment of Gustilo type II of tibial and fibula fractures have good clinical curative effect .Minimally invasive percutaneous plate osteosynthesis revealed shorter operation time , fracture healing is relatively fast , long-term effect is good , but the incidence of infection of fixation for the treatment is low .