经皮微创内侧锁定板固定治疗胫骨下段骨折

目的观察经皮微创钢板固定（minimally invasive percutaneous plate osteosynthesis,MIPPO）技术治疗胫骨下段骨折的临床疗效。方法对2009年1月至2011年2月收治的29例胫骨下段骨折病例采用MIPPO技术结合锁定加压接骨板（locking compression plate,LCP）治疗,其中男23例,女6例;年龄20~71岁,平均47.7岁。对临床疗效进行回顾性分析。结果其中26例获得随访,时间12~24个月,平均14个月。1例软组织感染,骨折均愈合,愈合时间3~6个月,平均4.2个月。按Johner-Wruhs评分标准评定疗效,其中优23例,良2例,可1例,优良率为96.2%。结论采用MIPPO技术结合LCP治疗胫骨下段骨折,具有创伤小、手术时间短、骨折愈合率高、功能好的优点,是治疗胫骨下段骨折的理想方法。但需重视小腿内侧软组织条件,严格掌握适应证,避免软组织并发症。

Minimally Invasive Percutaneous Locking Plate Fixation Technique for the Treatment of Medial Tibial Fractures

Objective To explore the clinical effect of percutaneous minimally invasive plate osteosynthesis（MIPPO）technique in the treatment of distal tibial fractures.Methods From 2009January to 2011February,29cases of distal tibial fracture cases were treated（male 23,female 6cases;age 20~71year old,average 47.7years old）by combining the technologies of MIPPO and LCP treatment.The effect was investigated by retrospective analysis.Results 26 cases were followed-up for 12~24months（average 14months）.All wounds healed,soft tissue infection occurred in only one case.The average fracture healing time was 4.2months（range,3to 6months）.According to Johner-Wruhs score to evaluate the curative effect,which was excellent in 23cases,good in 2cases,fair in 1cases,the excellent and good rate was 96.2%.Conclusion In treatment of distal tibial fractures,MIPPO technology combined with LCP is a good method with less trauma,shorter operation time,higher rate of fracture healing and functional recovery advantages.But we also need to attach importance to medial lower leg soft tissue conditions,strict control the indications,avoid soft tissue complications.