微创经皮锁定加压钢板固定接骨术治疗胫骨远端骨折

Minimally invasive percutaneous plate osteosynthesis of distal tibial fractures using locking compression plates

目的探讨使用锁定加压钢板经皮微创固定接骨术治疗胫骨远端骨折,并对其疗效进行分析。方法 2006年5月至2008年6月采用微创经皮锁定加压钢板固定接骨术治疗胫骨远端骨折32例,AO分型:43A型11例,43B型12例,43C型9例。术后定期门诊随访,观察负重和骨折愈合情况,根据踝关节活动范围、疼痛及步态等指标,采用Mazur评分评估踝关节功能。结果 32例患者随访8～23个月(平均11.2个月),伤口均一期愈合,无感染、骨折延迟愈合或畸形愈合发生。骨性愈合时间10～20周(平均13.6周),完全负重时间8～24周(平均11.7周)。根据Mazur的踝关节功能评分,优16例、良12例、可3例、差1例,优良率87.5%(28/32)。结论微创经皮锁定加压钢板固定接骨术治疗胫骨远端骨折具有微创、固定可靠、并发症少等优点,近期随访临床效果较为满意。

Objective To explore distal tibial fracture fixation with locking compression plate through minimally invasive percutaneous osteosynthesis technique and analyze the outcomes.Methods From MAY 2006 to JUNE 2008,32 patients with distal tibial fractures were treated using MIPPO combined with LCP in our department.According to the AO classification：type 43A 11 cases,type 43B 12 cases and type 43C 9 cases.Regular clinical follow-up was executed by us.The condition of weight bear and fracture union was observed.Range of motion,ankle pain and gait were analyzed to evaluate the function of ankle joint using Mazur criterion.Results All the patients were followed up from 8 months to 23 months（averaged 11.2 months）.The incision of all the cases had achieved primary healing.No infection,delayed union,nonunion or malunion occurred in this series.The bone union was detected at13.6 weeks（10 to 20 weeks）.The time of full weightbearing was11.7 weeks（range,8 to 24 weeks） postoperatively.According to Mazur ankle joint function scoring,of the 32 cases,there were 16 cases belonging to the excellent,12 the good,3 the fair and 1 the poor.The rate of the excellent and the good was 87.5%（28/32）.Conclusions MIPPO combined with LCP applied to treatment of distal tibial fractures has the advantages of minimal invasion,stable fixation and less complications,the short-term clinical effect is satisfactory.