不切开骨膜钢板内固定治疗胫骨骨折

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1、不切开骨膜钢板内固定治疗胫骨骨折作者：马兆强，张丽香，丛华，毕福海，于长征【摘要】目的比较微创钢板与传统钢板内固定治疗胫骨骨折的临床疗效。方法采用前瞻性研究，将1998年1月至2005年3月收治的60例胫骨骨折随机分为两组，两组条件均衡。其中一组采用微创切开复位限制性接触钢板内固定术(微创组)；另一组按传统的AO操作原则行切开复位内固定术(传统组)。对两组的手术时间及结果进行比较。结果全部病例随访12～18个月，平均14个月。微创钢板内固定治疗胫骨骨折组与传统切开组比较，手术时间微创组1.5h，传统组1.2h，差异比较无显著性意义(P＞0.05)。术后吸收热

2、时间微创组3.3d，传统组为5.3d，差异比较有显著性意义(P＜0.01)。骨折愈合时间微创组10.1周，传统组13.2周，差异比较有显著性意义(P＜0.01)。微创组无延迟愈合病例，传统组有5例延迟愈合，差异比较有显著性意义(P＜0.05)。两组均无不愈合病例。结论微创钢板内固定治疗胫骨骨折，手术操作简单、安全、不进一步加重骨膜软组织损伤、骨折愈合快、无延迟愈合和不愈合病例，符合微创生物学内固定观点。【关键词】胫骨骨折；骨折内固定术；前瞻性研究；微创　　MinimallyInvasiveOsteosynthesisforFracturesofthe11Ti

3、bi　　Abstract：ObjectiveToevaluatetheeffectofminimallyinvisaveplateosteosynthesisforfracturesoftibiaandcompareitwiththatoftraditionalplateosteosynthesis.MethodsFromJanuary1998toMarch2005，60patientswithtibialfracturewererandomlyassignedintominimallyinvasivegroupandtraditionalgroup.The

4、age，sex，fracturetypesandsofttissueconditionofthepatientsinbothgroupswerebasicallymatchedandbalanced.Thepatientsinonegroupweretreatedwithminimallyinvasiveplateinternalfixation(minimallyinvasivegroup)，whilethepatientsintraditionalgroupweretreatedwithtraditionalopenreductionandinterna

5、lfixationaccordingtoAOprinciples(traditionalgroup).Comparethetimeandresultsofoperationsintwogroups.ResultsAllpatientswerefollowedupfrom12to18monthswithanaverageof14months.Theoperativetimewas1.5hinminimallyinvasivegroupand1.2hintraditionalgrouprespectively，andtherewasnosignificantst

6、atisticaldifference(P＞0.05).Thepostoperativefeverofthepatientsinminimallyinvasivegroupsubsided3.3dand5.3dintraditionalgroup.Theclinicalhealingtimeofthefracturesinminimallyinvasivegroupwere10.1wand13.2wintraditionalgroup，therewassignificantstatistical11differencebetweenminimallyinva

7、sivegroupandtraditionalgroup(3.8，P＜0.01).Nodelayedunionhappenedinminimallyinvasivegroup，5casesofdelayedunionintraditionalgroupandnononunionoccurredinbothgroups，therewassignificantstatisticaldifference(χ2＝5.61，P＜0.05).ConclusionMinimallyinvasiveplateosteosynthesisforfracturesoftibia

8、isdescribedassimpleandsafe