L型锁定钢板微创治疗胫骨近踝关节的长节段粉碎性骨折

Treatment of long segment comminuted fracture of distal tibia with L-shape lateral distal tibial locking plate by minimally invasive percutaneous plate osteosynthesis

目的探讨胫骨远段外侧L型锁定钢板微创内固定治疗胫骨近踝关节的长节段粉碎性骨折的临床疗效。方法采用胫骨远段外侧L型锁定钢板结合MIPPO技术治疗18例胫骨近踝关节长节段粉碎性骨折患者。结果18例均获随访，时间12—24个月。骨折均愈合，愈合时间13—20周。按Johner．Wruhs评分标准：优12例，良5例，可1例。无骨不连、畸形愈合、深部感染及内固定失败等并发症发生。结论胫骨远段外侧L型锁定钢板结合MIPPO技术治疗胫骨近踝关节长节段粉碎性骨折，符合骨折治疗的微创、损伤控制理念，固定可靠，临床疗效满意。

Objective To summarize the operative experience and clinical results of the treatment for the long-seg- ment comminuted fractures of distal tibia with L-shape lateral distal tibial locking plate by the minimally invasive per- cutaneous plate osteosynthesis （MIPPO）. Methods 18 patients with long-segment comminuted fractures of distal tib- ia were performed the lateral M1PPO operation with L-shape locking plate. Results All patients were followed up （ranged 12 to 24 months） after surgery. The bony union time was 13 -20 weeks. There were no deep infection, fail- ure fixation, nonunion and malunion occulted in this group. According to criteria of Johner-Wruhs, the results were ex- cellent in 12 cases, good in 5, and fair in 1. Conclusions MIPPO with L-shape locking plate is a safe and effective technique for the treatment of long-segment comminuted fractures of distal tibia with the advantage of less invasion, steady fixation, low infection rate and higher union rate.