CAJ | 학술논문

背景：胫骨开放性骨折在临床上比较常见，并发症多、治疗困难，采取何种治疗方法，尤其是内固定方法，目前尚无统一认识。 　　目的：探讨应用微创经皮接骨板内固定技术（MIPPO）与带锁髓内钉（IMN）治疗开放性C2型胫骨骨折的临床疗效。 　　方法：2010年1月至2013年12月，选择性应用MIPPO和IMN技术治疗开放性C2型胫骨骨折89例，其中应用MIPPO治疗52例，应用IMN治疗37例，观察两组患者的手术时间、骨折临床愈合时间、术后并发症，采用Johner-Wruh胫骨骨折疗效评估标准评估患肢功能，评定应用MIPPO和IMN技术治疗开放性C2型胫骨骨折的临床疗效。 　　结果：所有患者均获得随访，随访时间为11~34个月，平均23.4个月。MIPPO组和IMN组的平均手术时间为71 min和65 min；平均愈合时间为（34.6±8.3）周和（32.1±9.6）周。MIPPO组出现2例感染、1例成角畸形、1例延迟愈合、1例不愈合；IMN组出现1例感染、1例旋转畸形、1例不愈合，两组术后并发症总发生率比较无统计学差异（P＞0.05）。 　　结论：MIPPO和IMN技术是治疗开放性C2型胫骨骨折的两种理想方法。
배경：경골개방성골절재림상상비교상견，병발증다、치료곤난，채취하충치료방법，우기시내고정방법，목전상무통일인식。 　　목적：탐토응용미창경피접골판내고정기술（MIPPO）여대쇄수내정（IMN）치료개방성C2형경골골절적림상료효。 　　방법：2010년1월지2013년12월，선택성응용MIPPO화IMN기술치료개방성C2형경골골절89례，기중응용MIPPO치료52례，응용IMN치료37례，관찰량조환자적수술시간、골절림상유합시간、술후병발증，채용Johner-Wruh경골골절료효평고표준평고환지공능，평정응용MIPPO화IMN기술치료개방성C2형경골골절적림상료효。 　　결과：소유환자균획득수방，수방시간위11~34개월，평균23.4개월。MIPPO조화IMN조적평균수술시간위71 min화65 min；평균유합시간위（34.6±8.3）주화（32.1±9.6）주。MIPPO조출현2례감염、1례성각기형、1례연지유합、1례불유합；IMN조출현1례감염、1례선전기형、1례불유합，량조술후병발증총발생솔비교무통계학차이（P＞0.05）。 　　결론：MIPPO화IMN기술시치료개방성C2형경골골절적량충이상방법。
Background:Open fracture of tibia is very common in clinic. But it is difficult to be treated because of high incidence of complications, and there has not been unified understanding to the choice of treatment methods, especially for internal fixation. Objective:To explore clinical outcomes of minimally invasive percutaneous plate osteosynthesis (MIPPO) and interlocking intramedullary nail (IMN) in treating open tibial fracture. Methods: Between January 2010 and December 2013, 52 patients with tibial fracture underwent MIPPO and 37 received IMN. All the open fractures were type C2. Operation time, healing time of fractures and postoperative complications were recorded. The function of affected extremities were evaluated by Johner-Wruh score. Results:The mean duration of follow-up was 23.4 months in all patients (range, 11-34 months). The operation time was 71 min in MIPPO group and 65 min in IMN group. The healing time was (34.6 ± 8.3) weeks in MIPPO group and (32.1 ± 9.6) weeks in IMN group. In MIPPO group, osteomyelitis occurred in 2 cases, malunion in 1, delayed union in 1 and nonunion in 1. In IMN group, osteomyelitis occurred in 1 case, malunion in 1 and nonunion in 1. There was no significant difference in the incidence of postoperative complications between MIPPO and IMN group (P>0.05). Conclusions:Both MIPPO and IMN are ideal therapies for open C2 tibial fracture.