【摘要】 目的 比较微创经皮钢板内固定技术(MIPPO)与胫骨交锁髓内钉(IMN)内固定治疗胫骨下段骨折的疗效。方法 根据治疗方法不同将74例胫骨下段骨折患者分为MIPPO组(采用MIPPO治疗，37例)和IMN组(采用IMN内固定治疗，37例)。比较两组手术情况、骨折愈合时间、临床疗效以及术后并发症发生率。结果患者均获得随访，时间12～25(16.27±9.28)个月。术中出血量、切口总长度IMN组少(短)于MIPPO组(P<0.01)，手术时间、住院时间两组比较差异均无统计学意义(P > 0.05)，首次部分负重时间IMN组早于MIPPO组(P<0.01)。骨折愈合时间、末次随访时疼痛VAS评分及Johner-Wruhs功能评估标准评价的疗效优良率、术后并发症发生率两组比较差异均无统计学意义(P > 0.05)。结论 MIPPO和IMN内固定治疗胫骨下段骨折均能获得良好的疗效，医师可根据患者的具体情况以及自身对不同手术方式的熟练程度选用。更多还原

【Abstract】 Objective To compare the efficacy of minimally invasive percutaneous plate osteosynthesis( MIPPO) and tibial interlocking intramedullary nail( IMN) internal fixation in the treatment of tibial shaft fracture. Methods The74 patients with tibial shaft fractures were divided into the MIPPO group( treated with MIPPO,37 cases) and the IMN group( treated with IMN internal fixation,37 cases) based on different treatment methods. The surgical conditions,fracture healing time,clinical efficacy,and postoperative complication incidence of the two groups were compared. Results All patients were followed up for 12-25( 16. 27 ± 9. 28) months. The intraoperative blood loss and total incision length in the IMN group were less( shorter) than those in the MIPPO group( P < 0. 01). There were no statistically significant differences in the operation time and hospital stay between the two groups( P > 0. 05). The first partial weight-bearing time in the IMN group was earlier than that in the MIPPO group( P < 0. 01). There were no statistically significant differences in the fracture healing time,pain VAS at the last follow-up,the excellent-good rate of the efficacy evaluated with Johner-Wruhs functional criterion,and the incidence of postoperative complications between the two groups( P > 0. 05). Conclusions Both MIPPO and IMN internal fixation can achieve good therapeutic effects for tibial shaft fractures. Physicians can choose the appropriate method based on the specific conditions of the patients and their own proficiency in different surgical techniques.更多还原