微创钢板生物学内固定结合外固定架治疗胫骨粉碎性骨折

Treatment of comminuted tibia-fracture by combined minimally invasive plate biological osteosynthesis and external fixation

目的探讨微创钢板生物学内固定结合外固定架治疗胫骨粉碎性骨折的临床应用价值。方法先在胫骨前外侧置放外固定架并适当加压,然后在胫骨前内侧置放微创钢板固定。结果34例患者获得随访,时间6～22个月,平均11个月;临床愈合时间6～12周,平均9周;骨性愈合时间3～7个月,平均5个月。根据Mazur的评价标准,本组病例中优29例,良5例。结论此方法既克服了单纯微创钢板生物学内固定在胫骨粉碎性骨折应用中的不稳定性,又避免了外固定架长期固定容易引起针道感染及渐进性移位的缺点。

Objective To explore the clinical practicality in the treatment of comminuted tibia-fracture by combined minimally invasive plate biological osteosynthesis and external fixation. Method The initial step is to install an external fixation support, properly pressed, on the outer fore-tibia, and then to place minimally invasive plate, properly fixed, on the inner fore-tibia. Result The observation concerns a random sampling of 34 patients, covering a period from 6 to 22 months with an average of 11 months; the clinical healing spans from 6 to 12 weeks with an average of 9 months; the osteological healing takes 3 to 7 months with an average of 5 months. In accordance with Mazur assessment criteria, 29 cases belong to A （the first grade） while 5 cases B. Conclusion This method is not only able to obliterate the instabilities in the clinical treatment of comminuted tibia-fracture by minimally invasive plate biological osteosynthesis only, but also to avoid the disadvantages of nailhole affections and potential displacements by external fixation.