微创钢板内固定技术治疗胫骨干骺端粉碎性骨折

Minimally invasive percutaneous plate osteosynthesi for comminuted fracture of metaphyseal tibia

目的 探讨微创钢板内固定（MIPPO）技术治疗胫骨干骺端或伴胫骨干粉碎性骨折的疗效.方法采用间接复位和微创钢板内固定技术治疗胫骨干骺端粉碎性骨折38例. 结果 经过10～30个月（平均18.6个月）的随访,全部Ⅰ期愈合.手术时间50～130 min（平均75 min）,不需输血.骨折愈合时间4.2～7.8个月（平均5.4个月）.按Johner-Wruhs方法评价：优26例,良10例,中2例,优良率为95%. 结论微创钢板内固定技术创伤小,并发症少,能促进骨折愈合,关节功能恢复满意,是治疗胫骨干骺端或伴胫骨干粉碎性骨折的有效方法.

Objective To discuss the curative effect of minimally invasive percutaneous plate osteosynthesis （MIPPO） in treatment of comminuted fracture of metaphyseal tibia. Methods The study involved 38 patients with comminuted fracture of metaphyseal tibia treated by indirect reduction and MIPPO. Results All patients were followed up for 10-30 months （average 18.6 months）, which showed one stage union in all patients. The time for bony union was 4.2-7.8 months （mean 5.4 months）. The operation lasted for 50-130 minutes （average 75 minutes）. According to Johner-Wruhs system, the outcome was excellent in 26 patients, good in 10 and fair in two, with satisfactory rate of 95%. Conclusion MIPPO takes advantages of minor trauma, few complication, simple manipulation, high success rate and satisfactory recovery of joint function recovery and bony union, and hence is a safe and effective treatment for comminuted fracture of metaphyseal tibia.