摘要目的 探讨经皮钢板内固定术(MIPPO)治疗PilonⅢ型骨折的临床疗效.方法 54例患者以就诊顺序结合随机号码,奇数进入观察组,偶数进入对照组,观察组28例采用MIPPO手术治疗,对照组26例采用内固定手术治疗,比较两组疗效.结果 观察组优良率85.7％,对照组优良率76.9％,两组差异有统计学意义(Ridit z=12.658,P=0.000).观察组骨痂出现时间(8.1±1.6)周,骨折愈合时间(6.5±1.2)个月,无再骨折发生；对照组骨痂出现时间(9.4±2.1)周,骨愈合时间(7.1±1.1)个月,1例再骨折；两组骨痂出现时间和骨愈合时间差异有统计学意义(t=7.865、8.632,均P＜0.05).结论 MIPPO治疗pilon Ⅲ型骨折疗效显著,对踝关节功能恢复效果明显.

abstractsObjective To explore the effect of minimally invasive percutaneous plate osteosynthesis (MIPPO) operation in the treatment of Pilon type Ⅲ fractures.Methods 54 patients were randomly divided into 2 groups by visiting sequence with random number,odd into the observation group,even into the control group.The observation group(28 cases) received MIPPO operation treatment,the control group(26 cases) was treated with fixed operation.The efficacy was compared between the two groups.Results The excellent and good rate was 85.7％ in the observation group,which was 76.9％ in the control group,there was significant difference between the two groups (Ridit z =12.658,P =0.000).In the observation group,the callus time was (8.1 ± 1.6) w,fracture healing time was (6.5 ± 1.2) m,no refracture occurred; in control group,the callus time was (9.4 ± 2.1) w,the fracture healing time was (7.1 ± 1.1)m,1 case occurred refracture,the differences of callus and bone healing time between the two groups were statistically significant (t =7.865,8.632,all P ＜ 0.05).Conclusion MIPPO operation in the treatment of Pilon type Ⅲ fracture has good effect,MIPPO can be used and promoted in the Pilon type Ⅲ fracture.