有限切开复位锁定钢板内固定治疗胫腓骨骨折

Treatment of tibial and fibula fractures adopting limited open reduction with Locking compression plate fixation

目的:探讨采用有限切开复位锁定钢板内固定治疗胫腓骨骨折的疗效。方法:自2004年7月～2009年8月应用小切口手指指引下复位,经皮置入钢板内固定治疗胫腓骨骨折62例。小切口间接复位后,在胫骨内侧骨折两端建立皮下隧道,钢板经此隧道安放在胫骨内侧骨膜外,少数螺钉固定。结果:平均手术时间85分钟,55～150分钟,无明显的术中和术后并发症。平均住院时间9.5天,6～15天,所有病例伤口均1期愈合,随访2～18个月,骨折临床愈合时间12～20周,平均16周,无骨折延迟愈合及不愈合,钢板固定可靠,未见断裂与松动。结论:采用经手指引导、有限切开复位锁定钢板内固定技术治疗胫腓骨骨折,具有创伤小、手术时间短、复位确实可靠、操作简单、并发症少、有利于骨折愈合的优点,是治疗胫腓骨骨折的有效方法。

Objective：To explore the use of limited open reduction with locking compression plate for tibial and fibula fractures.Methods：Since July 2004～August 2009 Application of limited open reduction under the guidance of a finger reset,indirect reposition and locking compression plate were performed to treat 62 cases of tibial fractures.A subcutaneous tunnel was created along the medial border of the tibia after indirect reposition,and then plate was inserted into the subcutaneous tunnel which lied upon the extraperiosteal surface and fixed by screws.Results：The mean operative time was 85min （55min～150min） no significant intraoperative and postoperative complications.Average length of stay 9.5d （6d～15d）.All patients were followed up for 2～18 months.And bone fractures healed with an average healing time of 16 weeks without delayed union and nonunion.No infection and breaking or loss of plate had happened.Conclusion：Guide used by the fingers,limited open reduction and locking compression plate in the treatment of tibial and fibula fractures with less trauma and shorter operative time,reset reliable,simple operation of the advantages of fewer complications and promote bone healing.It might be a safe and effective way to treat tibial and fibula fractures.