解剖钢板微创治疗胫骨远、近端骨折

Minimally invasive anatomic plate fixation for proximal and distal tibial fracture

目的探讨解剖钢板微创治疗远、近端胫骨骨折的疗效。方法20例胫骨远、近端骨折患者采用不显露骨折处且以骨折处为中心,经皮2～3个小切口,解剖钢板内或外侧骨膜外插入桥接间接复位后骨折固定。结果20例均获随访,时间7个月～2年,均骨性愈合,愈合时间15～20周。无浅表和深部感染发生。术后4～6个月均下地行走,7个月后行走无跛行,膝、踝关节功能与伤前一致且双下肢对称。Iowa膝、踝关节评分由术前(50±6)分提高至术后(96±2)分。结论解剖钢板微创治疗胫骨远、近端骨折是一种有效的方法。符合美学要求和微创生物学内固定观点。

Objective To evaluate the effect of minimally invasive anatomic plate fixation for proximal and distal tibial fracture. Methods 20 cases of proximal and distal tibial fractures were undergone medial or lateral minimally invasire anatomic plate fixation without fracture exposure through 2 - 3 small incisions. Results 20 cases were followed up for 7 -24 months. All got bony union in 15 -20 weeks. No superficial or deep infection was found. All were permitted walking in 4 - 6 months. All got no limp in 7 months. The knee and ankle function got complete reeovery. Iowa grade on knee and ankle was restored from 50 ± 6 to 96 ± 2. Conclusions Minimally invasive anatomic plate fixation is effective for proximal and distal tibial fracture, which is accordant to the cosmetic and biologic demand.