MIPPO技术治疗闭合性胫腓骨骨折临床疗效的对照研究

目的探讨经皮微创钢板内固定技术（MIPPO）治疗闭合性胫腓骨骨折的临床疗效。方法对我科收治并采用MIPPO技术治疗的闭合性胫腓骨骨折患者67例进行临床疗效观察（微创手术组）；搜集以前我科收治并行传统开放术式钢板内固定治疗的闭合性胫腓骨骨折患者资料72例（传统手术组）；对照分析两种术式的临床疗效：手术时间、术中出血量、切口长度、术后骨折愈合情况等。结果所有患者均康复出院，未发生术后大出血、感染、重要血管、神经、肌腱损伤等术后并发症；经9～30个月随访，微创手术组所有患者患肢均活动良好，未发生关节僵硬；X线检查显示．胫腓骨骨折愈合良好，未发生骨折不愈合或延迟愈合、内固定物松脱、断裂等并发症：传统手术组出现4例骨折不愈合或延迟愈合，行二期手术植骨后骨折愈合良好；3例发生钢板、螺钉断裂，行二期手术取出内固定物重新内固定后，骨折愈合良好。结论与传统内固定术式相比，MIPPO技术在闭合性胫腓骨骨折的治疗中，可以显著促进骨折愈合，降低内固定物的应力遮挡，减少内固定物松脱、断裂的几率；在闭合性胫腓骨骨折的治疗中具有极高的临床推广应用价值。

Comparative study of MIPPO operating method for closed fracture of the tibia and fibula

Objective To confirm the clinical result of minimally invasive percutaneous plate osteosynthesis(MIPPO) for closed fracture of the tibia and fibula.Methods The hospitalizing data of 67 cases suffered from closed fracture of the tibia and fibula was collected,which were undergone MIPPO operation(MIPPO group);meanwhile the hospitalizing data of 72 cases suffered from closed fracture of the tibia and fibula was collected,which were undergone traditional plate osteosynthesis(Tradition group).Operating time,operating bleeding volume,operating length and fracture complications postsurgery were analyzed statistically between the two groups.Results In our study,all patients healed,no operating complications occurred,such as postoperative bleeding,infection,blood vessel injury,nerve injury,tendon injury.The function of all the injured limbs in MIPPO group recovered,no anchylosis occurred;X-ray showed,the fracture of tibia and fibula healed,no fracture nonunion,no palate fractured,no screw loosened.4 cased of fracture nonunion and 3 cases of plate fracture occurred in the tradition group,which needed to undergo another operation to cope with the problem.Conclusion Contrast to the tradition group,MIPPO used for closed fracture of the tibia and fibula could promote the fracture to be cured,descend the efficiency of palate fracture,which is worth to be used publicly.