锁定钢板治疗四肢骨折45例

Locking plate for treatment of extremities fracture:a report of 45 cases

目的：探讨锁定钢板在四肢骨折内固定中的运用方法和注意事项。方法：采用AO微创固定系统（less invasivestabilization system,LISS）和锁定加压接骨板（locking compress plate,LCP）等治疗四肢骨折45例51处。22例股骨远端与胫骨近端骨折采用LISS固定,其余骨折采用LCP治疗。通过间接复位、微创技术等,于肌层下骨膜外闭合插入,完成锁定钢板的固定。结果：术后干骺端骨折均恢复关节面的高度,骨干骨折无明显旋转和成角畸形。随访1-17个月余,切口无感染和延迟愈合,无骨不连、关节面高度丢失、骨折再移位、成角畸形、螺钉拔出、钢板断裂等并发症。所有骨折均愈合,临床愈合时间8-16周。术后12-16周均能弃拐行走或正常持物,患肢功能恢复良好。结论：锁定钢板治疗四肢骨折,具有软组织创伤小、感染率低、骨折愈合快、肢体功能恢复好等优点。

Objective：To investigate the application of locking plate in treatment of the extremities fracture.Methods：Forty-five cases（51 fractures）of the extremities fracture were treated with less invasive stabilization system（LISS）or locking compress plate（LCP）by indirect reestablishment and minimally invasive techniques.Twenty-two patients with distal femoral or proximal tibial fractures were treated with LISS,and the others were treated with LCP.Results：All the cases were followed up for 1-17 months.No wound infection,delayed union,bone nonunion,loss of height of articular surface,displaced or angulationfracture,screw extraction or plate fragmentation occurred.The healing time of the fracture was 8-16 weeks.The patients were able to walk without support or grip after 12-16 weeks.The function of all the extremities restored well.Conclusions：Treatment of extremities fracture using locking plate with minimally invasive plate osteosynthesis techniques has the advantages of less soft tissue trauma,less damage to the blood vessel of the bone or periosteum,lower infection rate,rapid union and satisfactory function recovery.