【摘要】 目的比较锁定和非锁定中和钢板结合经皮微创钢板内固定技术(MIPPO)治疗AO分型中A型胫骨远端骨折的临床疗效。方法回顾性分析自2011-01—2013-06诊治的AO分型中A1、A2型胫骨远端骨折51例,分别采用锁定钢板和非锁定钢板作为中和钢板结合MIPPO技术进行治疗,锁定钢板组28例,非锁定钢板组23例。比较2组手术时间、术中出血量、内固定材料费用、骨折愈合时间、术后1年AOFAS评分及并发症情况。结果 51例均获得随访,平均随访18.8(12~23)个月。2组各有1例切口出现浅表感染,口服抗生素及定期换药后好转。2组手术时间、术中出血量、骨折愈合时间、术后1年AOFAS评分比较,差异无统计学意义(P>0.05)。非锁定钢板组内固定材料费用明显低于锁定钢板组,差异有统计学意义(P<0.001)。锁定钢板组中出现钢板刺激症状的患者少于非锁定钢板组,2组比较差异有统计学意义(χ2=3.99,P<0.05)。至末次随访时,锁定钢板组14例已经或希望取出钢板,而非锁定钢板组为18例,2组差异有统计学意义(χ2=4.31,P<0.05)。结论锁定和非锁定中和钢板结合MIPPO技术治疗A型胫骨远端骨折的临床疗效相似,但采用锁定钢板费用较高。更多还原

【Abstract】 Objective To compare the clinical,radiologic,and cost-effectiveness results between locking and non-locking neutralization plates with MIPPO technique to treat the extra-articular type A distal tibial fractures.Methods A total of 51 patients enrollment with AO/OTA 42-A1,A2 distal tibial fractures were treated from January 2011 to June 2013.Twenty-eight patients were treated with a locking plate and 23 patients were treated with a non-locking plate.Surgical time,bleeding,plate costs,bone union time,AOFAS scores 1 year after surgery and complications were compared between the two fixation groups.Results All patients were followed up.The mean follow-up was 18.8 months(12-23 months).Each group had one patient that experienced superficial infection; these wounds were readily healed by oral antibiotics and dressing changes.There were no significant differences between the groups in surgical time,bleeding,bone union time,or AOFAS scores(P >0.05).The cost of the non-locking plate was obviously cheaper than the cost of the locking plate(P <0.001).To date,five patients in the locking group and ten patients in the non-locking group had sensations of metal stimulation or other discomfort(χ2=3.99,P <0.05).Until the last follow-up,14 patients in the locking plate group and 18 patients in the non-locking plate group had their plates already removed or wanted to have their plates removed(χ2=4.31,P <0.05).Conclusion The use of locking or non-locking plates provides a similar outcome in the treatment of type A distal tibial fractures.However,the expenses of locking plate is much more than that of the non-locking plate.更多还原