2型糖尿病并胫骨远端骨折经皮微创钢板固定治疗探讨

Type 2 diabetes and distal tibial fractures minimally invasive percutaneous plate fixation observed

目的探讨在2型糖尿病并胫骨远端骨折患者治疗中应用经皮微创钢板固定技术的临床效果,为临床提供有依据的治疗经验及方法。方法选择该院收治的2型糖尿病并胫骨远端骨折患者16例,其中男10例,女6例;平均年龄（60.12±2.3）岁,骨折位置：左侧5例,右侧11例,多发4例,单发骨折12例。依据AO分型：A1型4例,A2型2例,A3型4例,B1型3例,B3型2例,C1型1例。骨折后至手术时间平均（2.31±13.56）d。结果随访时间为9~12个月,平均（10.31±1.82）个月,平均手术时间（89.34±1.45）min,术中平均失血量（285.51±2.45）m L,术后1年疗效应用JohnerWruhs法予以评估,优：6例,良4例,中4例,差2例。X线检查显示14例患者骨性愈合,无复发,2例患者出现泌尿系统感染,1例呼吸系统感染。结论经皮微创钢板固定治疗2型糖尿病并胫骨远端骨折,固定牢靠,切口小,符合生物学固定理论,减少了对周围组织的剥离,并发症较少,有推广意义。

Objective To explore the treatment of type 2 diabetes and Tibia in minimally invasive percutaneous plate osteosynthesis clinical results distal fracture patients, provide the basis for clinical treatment experience and methods. Methods To choose our hospital type 2 diabetes and distal tibial fractures were 16 cases, including 10 males and 6 females;mean age of（60.12 ± 2.3） years, fracture location： Left five cases, the right side in 11 cases, multiple 4 cases, 12 cases of single fracture. According to AO classification： A1 type 4 cases, A2 type 2 cases, A3 type 4 cases, B1 type 3 cases, B3 type2 cases, C1 type 1 cases. The average time to surgery after fracture（2.31 ±13.56） d. Results Follow-up time is 9-12 months, the average（10.31±1.82） months, the average operation time（89.34±1.45） min, median intraoperatie blood loss was（285.51 ± 2.45） m L, 1 years after Johner- Wruhs method was applied to evaluate curative effect, optimal： 6 cases, 4 cases,in 4 cases, 2 cases. X-ray examination showed 14 cases of patients with osseous healing, no recurrence, 2 cases of patients with urinary system infection, 1 case of respiratory system infection. Conclusion The Minimally invasive percutaneous plate fixation in the treatment of type 2 diabetes and distal tibial fractures, stable fixation, small incision, in line with the theory of biological fixation, reducing the surrounding tissue stripping, fewer complications, there is the promotion of significance.