MIPPO結(jié)合間接復位與微笑切口治療鎖骨骨折：功能恢復與美容效果對比研究

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中圖分類號：R687.3 文獻標志碼：ADOI：10.7652/jdyxb202503019

MIPPO combined with indirect reduction and smile incision for clavicle fractures ： a comparative study on functional recovery and cosmetic outcomes

QU Li'an，ZHAO Xiaoming，LI Meng，JI Wenchen，LIU Kai， ZHANG Yingang （Department of Orthopedics，The First Affiliated Hospital of Xi'an Jiaotong University，Xi'an 7loo6l，China）

ABSTRACT：ObjectiveTocompare thesmile incision combined with indirect reduction technique with traditional ORIFtechnique andsystematicall evaluate theadvantages of this innovativesurgicalmethodin terms offunctionalrecovery and postoperative cosmetic efects.MethodsA total of 6Opatients with midshaft clavicle fractures were enroled betwen October 2022 and August 2O24.The patients were randomly asigned to either ORIF group（open reduction and internal fixation， n=30 ）orMIPPO group （MIPPO combined with smile incision， n=30） .Outcomes assessed included surgical trauma，functional recovery，and cosmetic outcomes.ResultsThe MIPPO group exhibited significantlyreduced intraoperative blood loss [（32.9±7.6）mL VS. （90.2±14.0）mL ， P<0.05] ，shorterincision length .（8. （204號 5±1.2）cm ， P<0.05] ，and reduced operative time compared to the ORIF group.Functional recovery indicators such as bone healing time weeks vs. （12.8±2.0） weeks， P<0.05] ，initial and complete self-care time，and weight-bearing recovery were allsignificantly improved in the MIPPO group.The Constant-Murleyscore was higher in the MIPPO group （91.5±5.1 vs. 82.4±6.0 ， P<0.05） .Cosmetic outcomes also favored the MIPPO group，with a superior SBSES score （9.2±0.4νs.3.0±0.7 ， ）and better results in scar visibility，pigmentation，thickness， and elasticity.ConclusionThe smile incision combined with indirect reduction technique significantly reduces surgical trauma，acelerates postoperative recovery，and provides substantiallybetter cosmetic outcomes compared to conventional methods，making it particularly suitable for patients with high aesthetic expectations.

KEY WORDS： clavicle fracture； minimall invasive plate osteosynthesis （MIPPO）； indirect reduction technique;smile incision

鎖骨骨折是臨床常見損傷1，傳統(tǒng)切開復位內(nèi)固定（open reductionand internal fixation，ORIF）術后常遺留明顯瘢痕、組織損傷較大[2]，患者術后恢復較慢、滿意度低[3-4]，而傳統(tǒng)微創(chuàng)技術（如minimallyinvasiveplateosteosynthesis，MIPPO）則因復位困難、切口設計不合理，應用受限[5-7]。（剩余9067字）