微创经皮内固定治疗胫骨中下段骨折的临床观察

Minimally invasive percutaneous plate osteosynthesis with locking plate for comminuted tibia fractures

目的探讨微创经皮钢板植入内固定技术治疗胫骨骨折的临床效果。方法回顾我院2013年1月~2014年5月,经皮小切口用锁定钢板微创内固定治疗胫骨骨折,选取随访资料完整者20例,其中胫骨远端骨折9例,胫骨中段骨折11例,应用手法复位及器械辅助复位骨折,经皮微创置入锁定钢板至骨膜外,经皮打入锁定螺钉固定骨折。对于骨折经皮复位不满意病例行有限切开复位内固定。观察其治疗效果,并总结分析。结果获得完整随访资料的20例患者,随访时间5~14个月,平均11个月。手术切口均愈合良好,无感染,无皮肤坏死。骨折复位均满意,骨折愈合亦满意,平均愈合时间术后18周。采用Johner-Wruhs胫骨骨折治疗评分标准,优15例,良3例,中2例,差0例;优良率为90.0%。结论微创经皮钢板内固定技术创伤小,骨折端血供破坏少,骨折愈合率高,并发症少,是治疗胫骨中远段骨折的理想方法之一。

Objective To evaluate the methods and effect of minimally invasive percutaneous plate osteosynthesis with locking plate for comminuted tibia fractures. Methods From January 2013 to May 2014,20 patients of tibia fractures were treated by minimally invasive percutaneous incision with locking plate. Indirect reduction technology was used to reset fractures. Through a small incision outside distal tibia established a tunel outside tibia periosteal, and then insert locking plate fixing the fracture. To investigate the clinical curative effect. Results All 20 cases were followed-up, from 5 to 14 months, and all incisions were healed at first time. Fractures healed without delay, malunion, and average healing time was 16 weeks. According to Johner-Wruhs scale, there were 15 cases excellent, 3 cases were good, 2 cases fair, no case was bad. The excellent and good rate was 90.0%. Conclusion Minimally invasive percutaneous plate osteosynthbesis with locking plate is a ideal method to treat the tibia fractures, which can protect the soft tissue, reduce destruction to the blood supply of fracture, promote bone healing, reduce the complications.