MIPPO与超关节外固定支架对Gustilo Ⅱ型开放胫骨远端骨折患者踝关节功能的影响

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Abstract Objective To compare and analyze the clinical effects of minimally invasive percutaneous plate osteosynthesis (MIPPO) and over-articular external fixation in the treatment of Gustilo typeⅡopen distal tibial fractures，and to explore the effects of the two operations on the patient's ankle joint function.Methods In this retrospective study，122 patients with Gustilo type Ⅱopen distal tibial fractures in our hospital from January 2018 to January 2017 were divided into two groups according to different surgical plans.There were 61 cases in each group.Group A was treated with MIPPO，and group B was treated with super-articular external fixation.The operation and postoperative recovery，excellent and good rate of recovery of ankle joint function，incidence of postoperative complications and dorsal artery of the affected limbs [systolic flow (SF)，diastolic flow (DF)，time average maximum (TAM)，resistance index (RI)，stress index [procalcitonin (PCT)，interleukin-6 (IL-6)，prostaglandin E-2 (PGE-2)，substance P (SP)]，hemodynamic parameters of the pain degree and Lowa ankle score were compared between the two groups.Results The operation time，swelling subsided time，and average hospital stay in the A group were shorter than those in the B group (P<0.05).The excellent and good rate of recovery of ankle joint function in the A group (95.08%) was higher than that of the B group (81.97%)，P<0.05.Serum levels of PCT，IL-6，PGE-2，and SP in the A group were lower than those in the B group at 1，3，and 7 days after operation (P<0.05).The SF，DF and TAM of the dorsal foot arteries of the affected limbs in the A group were higher than those in the B group at 1，3，and 7 days after the operation，and the RI was lower than that in the B group (P<0.05).The total incidence of postoperative complications in the A group (11.48%) and the B group (9.84%) were not statistically different (P＞0.05).The exercise VAS score and resting VAS score of the A group were lower than those of the B group at 3 months，6 months，and 12 months after the operation，and the Lowa ankle score was higher than that of the B group (P<0.05).Conclusion Compared with over-articular external fixation，the clinical effect of MIPPO in the treatment of Gustilo Ⅱ type open distal tibial fracture is better，and it can further improve the recovery of ankle joint function.

Key words： distal tibial fracture super-articular external fixation frame minimally invasive percutaneous plate osteosynthesis ankle joint function

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	Liu Yan
	Xing Jianfei
	Song Shaofeng
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Liu Yan,Xing Jianfei,Song Shaofeng, et al. The Influence of MIPPO and Super-Articular External Fixation on the Ankle Function of Patients with Gustilo Type Ⅱ Open Distal Tibial Fracture[J]. sygkzz, 2021, 27(6): 506-511.

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http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2021/V27/I6/506

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