MIPPO技术治疗下肢骨折患者的康复功能锻炼

Rehabilitation Training of Patients with Lower Limb Fractures Treated by MIPPO

目的探讨总结MIPPO技术(Minimally invasive percutaneous plate osteosynthesis,微创经皮钢板植入术)治疗下肢骨干骨折病人围手术期康复功能训练的方法。方法对2004年2月～2008年12月收治的77例下肢股骨干骨折病人运用MIPPO技术治疗的患者,在骨愈合早期、中期、后期对患者施行个体化的、循序渐进的、有计划的功能康复训练。结果有4例出现延迟愈合,其余均在4周复查X光,可见骨折端骨痂生长,14周骨折端出现大量骨痂,骨折线消失,无骨不连,无内固定物松脱及感染,无股四头肌萎缩,无畸形愈合,无患肢短缩增长。随访13.6个月(4个月～30个月),膝关节活动功能恢复良好,优良率93.3%。局部皮肤出现水泡5例;无伤口感染和皮肤坏死病例。结论MIPPO技术下运用LCP治疗四肢骨折具有微创、并发症少、手术操作简易、适应范围广、效果确切美观等特点,固定可靠,愈合率高,皮肤软组织感染发生少的优点,术后病人能早期功能锻炼、早期负重,减少护理并发症发生。

Objective To explore perioperative rehabilitation training of patients with lower limb fractures treated by MIPPO （Minimally invasive percutaneous plate osteosynthesis ）. Methods MIPPO was used in treatment of 77 cases of femoral shaft fractures of lower limb, which were treated from February 2004 to December 2008. The patients were made to carry on an individualized, step-by-step and planned rehabilita- tion of the function in the early, middle and late period of bone healing. Results 4 cases had delayed healing, and the remaining were reviewed in the X-ray in four weeks to see the growth of fracture callus. After 14 weeks, a large number of fracture callus formed, fracture line disap- peared, no nonunion, non-loosening and infection inside the fixture, without quadriceps contraction, no malunion, non-growth of limb shorten- ing. Follow-up of 13.6 months （4 months to 30 months）： good knee function recovery activities, the excellent rate of 93.3%. 5 cases of local skin blisters; no wound infections and cases of skin necrosis. Conclusion In MIPPO technology, the use of LCP technology has the characteristics of the treatment of limb fractures： minimally invasive, fewer complications, simple operation to adapt to a wide range, exact effects as well as good appearance. In addition, it has the advantages of solid fixation, high rate of wound healing, less infections of skin and soft tissues so that postop- erative patients can do early functional exercises with early weight-bearing and fewer nursing complications.