经皮微创锁定加压钢板治疗胫骨骨折

Treatment of tibial fractures with locking compression plate combined with minimally invasive percutaneous plate osteosynthesis technique

目的:回顾总结应用锁定加压钢板(LCP)结合微创接骨板内固定术(MIPPO)治疗胫骨骨折的临床疗效。方法:应用锁定加压钢板结合微创接骨板内固定术治疗胫骨骨折46例,按AO/ASIF分类:A型8例,B型11,C型27例,其中开放性骨折9例(Gustilo分型:Ⅰ型5例,Ⅱ型4例)。采用闭合间接复位或有限切开复位,复位后以MIPPO技术置入LCP桥接固定,对于31例伴有腓骨骨折,先予腓骨切开复位重建锁定钢板或1/3圆钢板固定。术后1、3、6、12个月复查,分别进行查体、X线评估及康复指导。结果:所有患者术后随访3～15个月,其中2例患者发生钢板断裂,1例重新手术,1例断裂后予石膏固定后愈合,其余患者骨折均愈合,平均愈合时间3.6个月(3～10个月)。功能评价采用Johner—Wruhs评分标准:优37例,良7例,差2例,优良率为96%。结论:应用锁定加压钢板结合微创接骨板内固定术治疗胫骨骨折可最大限度的保护骨折端血运,促进骨折愈合。

Objective：To summarize the efficacy of locking compression plate combined with minimally invasive percutaneous plate osteosynthesis technique in treatment of tibia] fractures. Methods：46 cases of tibia] fractures were treated with locking compression palate combined with minimally invasive percutaneous plate osteosynthesis（MIPPO） technique. According to AO/ASIF classification, 8 cases belonged to type A. 11 to type B, and 27 to type C. Among them, 9 cases were open fractures （Gustilo classification： 5 cases belonged to type I, 4 to type II ）.After indirect reduc- tion or limited open reduction, all the patients were treated with locking compression plate combined with MIPPO technique. 31 cases complicated with fibula fractures were first treated with open reduction and reconstruction locking plate or 1/3 round palate fixation.Results：46 cases were followed up for 3-15 months. Except 2 cases of plate break- ages, all the patients received clinic union, and the average clinic union time was 3.6 months （3-10months）. The out- come was excellent in 37 cases, good in7 cases and fair in 2 case according to Johner-Wruhs standard. Conclusion： LCP combined with MIPPO is a good technique for treatment of tibia] fractures.