经皮微创接骨板治疗胫骨长节段粉碎性骨折

The Long-segment Comminuted Fracture of Tibia Treated with Minimally lnvasive Percutaneous Plate Osteosynthesis

目的：总结经皮微创接骨板技术（MIPPO）治疗胫骨长节段粉碎性骨折的手术经验和临床效果。方法：采用MIPPO技术治疗胫骨长节段粉碎骨折25例，均为新鲜骨折，其中开放性骨折5例，闭合性骨折20例。结果：全部病例获得随访，随访时间1～2．5a，平均1、8a。25例骨折均愈合。临床愈合时间16周（12～24周），无浅表和深部感染发生，无畸形愈合，无内固定失效。按Johner-Wruhs评分标准，优14例，良9例，可2例，优良率92％。结论：MIPPO治疗胫骨长节段粉碎骨折具有创伤小、固定确实、感染率低、骨折愈合率高等优点，符合生物学固定理念，是一种好的治疗方法。

Objective ：To summarize the operative experience and clinical results of the minimally invasire percutaneous plate osteosynthesis （MIPPO） in the treatment of the long-segment comminuted fractures of tibia with. Methods：Twenty-five patients underwent the MIPPO operation in our department, including 5 cases suffered from open fractures and 20 cases with closed fractures. Results：All patients were followed-up for 1 to 2.5 years after surgery, an average of 1.8 years. The clinical healing durations were 12 to 24 weeks, an average of 16 weeks, without superficial and deep infections. No malunion and ineffective internal fixation were observed. According to Johner-Wruhs＇criteria, there were excellent in 14 cases, good in 9, fair in 2. The ratio of excellent and good was 92%. Conelusion：MIPPO is a safe and effective technique for treating the long-segment comminuted fractures of tibia, which have advantages of minimal invasion, steady fixation, lower infection rate and higher union rate, meet the request of biological fixation.