微创经皮插入钢板治疗胫骨骨折

Minimally invasive percutaneous plate osteosynthesis to treat tibial fractures

目的比较微创经皮钢板固定技术(MIPPO)与传统切开有限接触加压钢板(LC-DCP)固定治疗胫骨骨折的临床疗效。方法将71例胫骨骨折病人随机分为两组,MIPPO组37例采用微创经皮插入钢板治疗,LC-DCP组34例采用传统切开有限接触加压钢板固定治疗。按Johner-Wuhs方法评价两组临床疗效。结果MIPPO组骨痂形成时间平均6.4周,骨折临床愈合时间平均12.8周;LC-DCP组骨痂形成时间平均8.2周,骨折临床愈合时间平均17.2周,MIPPO组优良率81.1%,LC-DCT组优良率73.15%。结论微创经皮钢板固定符合生物接骨原理,有利于骨折愈合,治疗胫骨骨折避免了传统方法的弊端。

Objective To evaluate and compare the clinical results of two treatment strategies to cure tibial fractures, one is minimally invasive percutaneous plate osteosynthesis （MIPPO）, the other is LC-DCP. Methods Along with the development of operation methods from internal fixation with steel plate to biological fixation, people started to use microinvasive operation to treat tibial fractures. From August 2005 to November 2007, our department has treated 37 cases of various tihial fractures by MIPPO; and got good results. 71 patients of tihial fractures were separated into two groups randomly, 37 cases by MIPPO and 34 cases by LC-DCP. There was little difference between these patients on the age ,gender and fracture type. Mean follow-up period was 18 months without missing. Results The mean period of porosis by MIPPO was 6. 4 weeks,and the mean period of clinical bone union was 12.8 weeks： whereas the mean periods were respectively 8. 2 weeks and 17. 2 weeks by LC-DCP. According to Johner-Wuhs evaluation methods, we got the excellent rate of 81.1% in MIPPO group, and 73.15% in LC-DCP group. Conclusion MIPPO has advantages in biological bone-knitting. At the same time, it can avoid disadvantages occurred in LC-DCP. MIPPO is significantly better than LC-DCP in the treatment of tihial fractures.