微创经皮钢板接骨术联合锁定加压钢板治疗胫骨远端骨折
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Minimally invasive percutaneous plate osteosynthesis combined with locking compression plate in the treatment of distal tibial fracture
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    目的:总结应用微创经皮钢板接骨术(Minimally invasive percutaneous plate osteosynthesis,MIPPO)联合锁定加压钢板(Locking compression plate,LCP)治疗胫骨远端骨折的临床疗效。方法:2009年1月至2011年2月,应用MIPPO技术联合LCP治疗20例胫骨远端骨折患者,通过临床及影像学两方面对患者骨折愈合情况、功能及并发症等进行评估。结果:20例患者均获随访,平均随访时间13个月(10~22个月)。20例患者骨折全部愈合,平均骨性愈合时间16周;无螺钉松动或断裂,无内固定失效发生。2例(10%)患者发生成角畸形愈合(<7°);6例(30%)患者出现轻微跛行;4例(20%)患者患侧踝关节活动度较对侧减少20°以上;3例(15%)患者未能恢复受伤前工作;1例(5%)患者发生晚期感染,经治疗后痊愈,按Baird-Jackson踝关节功能评分标准,优13例,良4例,中2例,差1例,优良率85%。结论:MIPPO技术联合LCP治疗胫骨远端骨折具有创伤小、固定牢靠、术后恢复快、并发症少等优点,是一种值得推广的治疗胫骨远端骨折的方法。

    Abstract:

    Objective:To observe clinical efficacy of minimally invasive percutaneous plate osteosynthesis(MIPPO) combined with locking compression plate(LCP) in the treatment of distal tibial fracture. Methods:Totally 20 patients with distal tibial fracture were treated by MIPPO combined with LCP from January 2009 to February 2011. The fracture healing,functional recovery and complication incidences were evaluated by clinical examination and radiographs. Results:All cases were followed up for 10-22 months(averaged 13 months). All patients had bony union with an average recovery time of 16 weeks. No case of screw loose or fixation failure was observed;2 cases(10%) suffered from angles malunion(less than 7°);6 cases(30%) suffered from claudication postoperatively;4 cases(20%) experienced the reduce of the motion range of the injured ankle by at least 20° than the other one;3 cases(15%) can not return to work;1 cases(5%) had infection at later stage,but cured after the treatment. According to Baird-Jackson scoring system,13 cases were graded as excellent,4 cases as good,2 cases as fair,1 case as poor and the excellent and good rate was 85%. Conclusion:With the advantages of minimally invasiveness,solid fixation,quick recovery and fewercomplications,MIPPO combined with LCP is effective in the treatment of distal tibial fracture thus need promoting in clinics.

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罗 刚,倪卫东,高仕长,宋昭君.微创经皮钢板接骨术联合锁定加压钢板治疗胫骨远端骨折[J].重庆医科大学学报,2012,37(7):626-629

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  • 在线发布日期: 2012-09-17
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