内侧入路微创经皮钢板内固定技术治疗胫骨远段闭合骨折

Medial approach combined with minimally invasive percutaneous plate osteosynthesis for distal tibial closed fractures

目的探讨内侧入路微创经皮钢板内固定(MIPPO)技术治疗胫骨远段闭合骨折的临床疗效。方法采用内侧入路MIPPO技术治疗18例胫骨远段闭合骨折患者。记录手术时间、术中出血量、骨折复位情况、骨折愈合时间、踝关节活动度及并发症发生情况,采用AOFAS踝关节评分评价疗效。结果患者均获得随访,时间9~26个月。手术时间85~120 min,术中出血量100~220 ml。骨折均对位对线可,踝关节面平整,关节间隙正常,患肢未见明显短缩、旋转和成角畸形。切口均愈合,无钢板外露及感染发生。骨折愈合时间4~10个月。末次随访时,AOFAS踝关节评分为95~100分;踝关节活动度:跖屈40°~45°,背伸40°~45°,内翻35°~40°,外翻30°~35°。结论内侧入路MIPPO技术治疗胫骨远段闭合骨折复位效果较好,软组织损伤小,疗效满意。

Objective To investigate the clinical effect of medial approach combined with minimally invasive percutaneous plate osteosynthesis(MIPPO)in the treatment of distal tibial closed fracture.Methods The 18 cases of distal tibial closed fractures were treated by medial approach combined with MIPPO technique.The operative time,intraoperative blood loss,fracture reduction,fracture healing time,ankle range of motion and complications were recorded,and the AOFAS ankle score was used to evaluate the efficacy.Results All patients were followed up for 9~26 months.The operation time was 85~120 min,and the intraoperative blood loss was 100~220 ml.All fractures were in alignment with the line,the ankle joint surface was flat,the joint space was normal,and no obvious shortening,rotation or angulation deformity was found in the affected limb.The incisions were all healed,without plate exposure or infection.Fracture healing time was 4~10 months.At the last follow-up,the AOFAS ankle score was 95~100 points.Ankle range of motion:plantar flexion was 40°~45°,dorsiflexion was 40°~45°,varus was 35°~40°,and valgus was 30°~35°.Conclusions The medial approach combined with MIPPO technique in the treatment of distal tibial closed fracture has better reduction effect,less soft tissue injury and satisfactory efficacy.