胫骨远端解剖型钢板内固定治疗胫骨远端骨折

Treatment of distal tibial fracture with distal tibial anatomic plate internal fixation

[目的]探讨解剖型钢板治疗胫骨远端骨折的手术方法和临床疗效。[方法]本院自2003年1月～2006年1月应用解剖型钢板治疗胫骨远端骨折65例，29例患者应用胫骨远端内侧解剖钢板固定，其余的36例患者应用胫骨远端外侧解剖钢板固定，术中微创操作。根据AO分型：A型13例，B型37例，C型15例。[结果]术后随访8～36个月（平均18个月），疗效评定标准采用Mazur等制定的踝关节症状与功能评分系统：优35例，良25例，可3例，差2例。术后所有患者获得骨性愈合，愈合时间为9～15周（平均11．5周）。[结论]选择合适的手术时间和术中微创操作，应用塑型良好的胫骨远端内、外侧解剖型钢板治疗胫骨远端骨折，手术操作相对容易，内固定钢板符合胫骨远端解剖特点，内固定牢固，可以获得良好临床疗效。

[ Objective]To investigate the curative effect and methods of distal tibia] fracture by open reductin and fixation with anatomic plate. [ Method] Sixty - five patients with distal tibial fracture were treated from January 2003 to January 2006 with internal fixation of anatomic plate （IFAP） , of which 29 cases were treated with medial IFAP, 36 with lateral IFAP. According to AO classification, there were type A 13 cases, type B 37 cases, type C 15 cases. [ Result] All cases were followed up for 8 to 36 months （averaged, 18 months） , and the results showed 25 cases excellent, 15 cases good, 3 cases fair, 2 cases poor by Mazur criterion. Fracture of all cases revealed bony union in 9 to 15 weeks （ averaged, 11.5 weeks）. There were 4 cases complicatied with partial necrosis of incision skin and healed after dressing, one case had postoperative necrosis of incisional skin and exposure of plate and improved after dressing. [ Conclusion]The application of IFAP in the treatment of distal tibia] fracture has advantages of convenient operation, rigid fixaitn with anatomical characteristics. It is a better minimally invasive internal fixaiton in the treatment of distal tibial fracture at right operatin time.