锁定加压钢板治疗胫骨远端骨折

Treatment of Distal Tibia Fracture with LCP

目的探讨锁定加压钢板(locking compression plate,LCP)治疗胫骨远端骨折的效果。方法对我院2001年1月至2005年2月采用LCP治疗的胫骨远端骨折,选择其中资料完整、随访有效者共42例,进行分析。年龄(45.3±7.2)岁,按AO分型A型10例,B型19例,C型13例。软组织好的病例早期切开复位LCP内固定,软组织条件不好的病例用阶段治疗,早期跟骨牵引,软组织恢复后二期切开复位,LCP固定。术后随访(13.5±2.3)个月。结果有1例切口裂开,2例切口浅表感染,换药后均很快愈合。骨折愈合时间为A型(17.5±3.5)周,B型(19.3±4.1)周,C型(21.4±4.3)周。无畸形愈合、不愈合、肢体缩短、关节面二期塌陷。根据Tornetta等临床治疗结果评价标准进行评价,术后12个月踝关节综合功能恢复情况优良率为A型100%,B型89.5%,C型76.9%。结论选择软组织损伤较轻的病例,把握正确的手术时机,采用LCP治疗胫骨远端骨折是一种好的微创的治疗方法。

Objective Approaching the effect of treatment of disal tibia fracture with Locking Compression Plate （LCP）. Methods We reviewed the distal tibia fractures treated in our hospital between Jan 2001 and Feb 2005.42 cases with complete data and effective follow-up were chosen and analyzed. Age was 45.3 ±7.2 years. According to AO classification, 10 cases were type A, 19 cases were type B and 13 cases were type C. Patients with good soft tissue condition were treated with staged-protocols. After the calcaneal traction in the first stage,the soft tissue recovered and then the patients were treated with open reduction and LCP internal fixation. The time of follow-up was 13.5 ± 2.3 months. Results One case suffered from disruption of wound. 2 cases suffered from the surface infection of incision. But they healed from changing of the dress in short term. The mean healing time was 17.5±3.5 weeks in cases of type A,19.3±4. 1 weeks in cases of type B and 21.4±4. 3 weeks in cases of type C. There was no patient with malunion, nonunion,shortening of limb or secondary clasp of articular surface. According to Tornetta clinical standard of therapeutic result. The rate of excellent and good comprehensive function of ankle was 100% in cases of type A, 89% in cases of type B and 77.4% in cases of type C at the postoperative 12 monthes. Conclusion For the patients with good soft tissue condition,the treatment with LCP at the right time is a good management protocol with minimally invasive.