两种不同手术方式治疗胫骨远端骨折疗效比较

尹进; 陈明; 王加飞; 郑红兵; 杨光辉

doi:10.11659/jjssx.02E024053

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两种不同手术方式治疗胫骨远端骨折疗效比较

骨关节专栏 | 更新时间：2024-09-29

- 两种不同手术方式治疗胫骨远端骨折疗效比较
- A comparative study of the efficacies of two different surgical methods for the treatment of distal tibial fractures
- 局解手术学杂志 2024年33卷第9期页码：759-763
- 作者机构：
  
  徐州医科大学附属宿迁医院/南京鼓楼医院集团宿迁医院骨科，江苏宿迁 223800
- 作者简介：
  
  杨光辉，E-mail：13305248199@189.cn
- 基金信息：
  
  江苏省重点研发计划(BE2019703);宿迁市指导性科技计划(Z2022045)
- DOI：10.11659/jjssx.02E024053
  中图分类号： R683.42
- 纸质出版日期：2024-09-25，
  
  收稿日期：2024-02-23，
- 稿件说明：
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尹进,陈明,王加飞等.两种不同手术方式治疗胫骨远端骨折疗效比较[J].局解手术学杂志,2024,33(09):759-763.

YIN Jin,CHEN Ming,WANG Jia-fei,et al.A comparative study of the efficacies of two different surgical methods for the treatment of distal tibial fractures[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(09):759-763.
尹进,陈明,王加飞等.两种不同手术方式治疗胫骨远端骨折疗效比较[J].局解手术学杂志,2024,33(09):759-763. DOI： 10.11659/jjssx.02E024053.

YIN Jin,CHEN Ming,WANG Jia-fei,et al.A comparative study of the efficacies of two different surgical methods for the treatment of distal tibial fractures[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(09):759-763. DOI： 10.11659/jjssx.02E024053.

摘要

目的

比较逆行胫骨髓内钉（RTN）与经皮微创接骨板（MIPPO）治疗胫骨远端骨折的疗效。

方法

回顾性分析于我院就诊并行手术治疗的55例胫骨远端骨折患者的临床资料，根据手术方式的不同将患者分为2组，RTN组（

=25）采用RTN治疗，MIPPO组（

=30）采用MIPPO治疗。比较2组患者手术相关参数（手术时间、术中出血量、术中透视次数及闭合复位成功率）、骨折愈合时间、术后6个月及末次随访时踝关节背伸活动度及美国足踝外科协会（AOFAS）踝-后足评分、围术期及随访期间并发症发生率。

结果

RTN组患者手术时间、术中出血量及术中透视次数均明显短/少于MIPPO组（

0.05）。术后6个月RTN组患者踝关节背伸活动度及AOFAS踝-后足评分大/高于MIPPO组（

0.05），2组患者骨折愈合时间、末次随访时踝关节背伸活动度和AOFAS踝-后足评分比较差异无统计学意义（

0.05）。RTN组患者的闭合复位成功率为72.00%，低于MIPPO组的96.67%（

0.05）。RTN组患者软组织相关并发症发生率明显低于MIPPO组（

0.05），而2组患者总体并发症发生率比较差异无统计学意义（

0.05）。

结论

RTN是治疗胫骨远端骨折的有效微创术式，与MIPPO相比，其具有创伤小、软组织并发症发生率低、关节功能恢复快的特点。

Abstract

Objective

To compare the efficacies of retrograde tibial nailing （RTN） versus minimally invasive percutaneous plate osteosynthesis （MIPPO） in the treatment of distal tibial fractures.

Methods

A retrospective analysis was conducted on the clinical data of 55 patients with distal tibial fractures who underwent surgery in our ho

spital.Patients were divided into two groups based on the different surgical methods，patients in the RTN group （

=25） were treated with RTN，and patients in the MIPPO group （

=30） were treated with MIPPO. The surgical parameters （operation time，intraoperative blood loss，intraoperative fluoroscopy times，and success rate of closed reduction），fracture healing time，ankle dorsiflexion range of motion and American Orthopaedic Foot and Ankle Society （AOFAS） ankle-hindfoot scores 6 months after operation and at the last follow-up，and the incidence of complications during perioperative period and follow-up were compared between the two groups.

Results

The operation time，intraoperative blood loss，and intraoperative fluoroscopy times in the RTN group were significantly shorter/less than those in the MIPPO group （

0.05）.The ankle dorsiflexion range of motion and AOFAS ankle-hindfoot score 6 months after operation in the RTN group were significantly greater/higher than those in the MIPPO group （

0.05）.There was no statistically significant difference in the fracture healing time，or ankle dorsiflexion range of motion and AOFAS ankle-hindfoot score at the last follow-up between the two groups （

0.05）.The success rate of closed reduction in the RTN group was 72.00%，which was lower than that of 96.67% in the MIPPO group （

0.05）.The incidence of soft tissue-related complications in the RTN group was significantly lower than that in the MIPPO group （

0.05），while there was no statistically significant difference in the overall incidence of complications between the two groups （

0.05）.

Conclusion

RTN is an effective minimally invasive surgical technique for the treatment of distal tibial fractures，characterized by minimal trauma，low incidence of soft tissue complications，and fast recovery of joint function compared with MIPPO.

关键词

胫骨远端骨折逆行胫骨髓内钉经皮微创接骨板

Keywords

distal tibial fracturesretrograde tibial nailingminimally invasive percutaneous plate osteosynthesis

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