摘要
目的：比较微创经皮钢板内固定与传统切开钢板内固定治疗近关节骨折的组织相容性反应。
方法：2005-08/2007-01徐州矿务集团第一医院骨科收治近关节骨折患者41例，根据手术方法不同分成条件均衡的两组：①传统切开组20例：按传统切开复位钢板内固定，切口略长于钢板长度。②微创内固定组21例：采用微创经皮钢板内固定。对两组患者切口长度、手术耗时、术中出血量、平均住院日以及术后反映材料与组织相容性的发热时间、肿胀消退时间、骨折愈合时间、软组织修复情况、术后关节功能测定等进行观察、记录。
结果：全部病例随访3~15个月，平均6个月。①与传统切开组比较，微创内固定组术中出血少，术后发热时间及平均住院日短，肿胀消退快，术后关节功能满意率明显提高，差异均有显著性意义（P﹤0.05）； 微创内固定组手术时间及骨折愈合时间短于传统切开组，但两者间差异无显著性（P > 0.05）。②微创内固定组无术后软组织坏死，无切口延迟愈合或感染，无骨折延迟愈合以及不愈合，无骨外露等并发症。
结论：微创内固定技术治疗近关节骨折软组织损伤轻、创伤反应小，术后恢复快，内植物置入并发症少，符合生物学要求，和传统切开相比有明显优势。
关键词：近关节骨折；微创；骨折固定术

江水华，郭开今，陈树祥，赵华，汤重喜，周景福，刘鹏，朱宗东.微创技术与传统切开方法置入钢板内固定材料治疗近关节骨折的组织相容性反应：同期非随机对照[J].中国组织工程研究与临床康复，2008，12(9):1635-1638
[www.zglckf.com/zglckf/ejournal/upfiles/08-9/9k-1635(ps).pdf]

Histocompatibility of minimally invasive percutaneous plate osteosynthesis versus traditional incision for internal fixation in the treatment of fracture near articulation: A non-randomized concurrent control study

Abstract
AIM: To comparatively analyze the histocompatibility of using the technique of minimally invasive percutaneous plate osteosynthesis (MIPPO) and traditional incision for fixation of fracture near articulation.
METHODS: Totally 41 cases were treated from August 2005 to January 2007 at Department of Orthopaedics, First Hospital of Xuzhou Coal Mining Groups. These patients were assigned into two groups. ①Twenty patients in traditional group received traditional incision for internal fixation, and the incision was longer than steel plate length. ②Twenty-one patients in the MIPPO group received MIPPO for internal fixation. Incision length, operation time, blood loss, average time of fever and hospitalization, recovery of detumescence, bone union time, soft tissue repair and postoperative joint function were measured in both groups.
RESULTS: Totally 41 cases were followed up from 3 to 15 months (averagely 6 months). ①The blood loss was less, average time of fever and hospitalization was shorter in MIPPO group than in traditional group, and recovery of detumescence was quickly and the satisfaction rate of postoperative joint function was high in MIPPO group（P﹤0.05）. The operation time and bone union time were shorter in the MIPPO group than in the traditional group（P > 0.05）. ②No soft tissue necrosis, nonunion or delayed union, or bone exposure in MIPPO group.
CONCLUSION: Technique of MIPPO for fracture near articulation is characterized by little trauma, quick functional recovery and high satisfaction rate of postoperative joint function. It provides biological fixation and has obvious advantages compared to traditional incision.

Jiang SH, Guo KJ, Chen SX, Zhao H, Tang CX, Zhou JF, Liu P, Zhu ZD. Histocompatibility of minimally invasive percutaneous plate osteosynthesis versus traditional incision for internal fixation in the treatment of fracture near articulation: A non-randomized concurrent control study.Zhongguo Zuzhi Gongcheng Yanjiu yu Linchuang Kangfu 2008;12(9):1635-1638(China)
[www.zglckf.com/zglckf/ejournal/upfiles/08-9/9k-1635(ps).pdf]