锁定钢板治疗四肢粉碎性骨折71例疗效分析

目的总结应用锁定钢板系统治疗四肢粉碎性骨折的经验与疗效。方法应用锁定加压钢板（lockingcompression plate,LCP）对71例四肢长骨粉碎性骨折进行治疗,28例骨折在影像增强器下进行闭合复位,37例骨折行有限切开帮助复位,6例骨折行完全切开复位。然后以微创经皮接骨技术（minimally invasive percutaneous osteosynthe-sis,MIPO）置入LCP进行桥式固定。结果平均手术时间98.2min（70～180min）,平均失血量100ml（50～400ml）。71例均得以随访,随访6～24个月,平均10.8个月。所有骨折均愈合,骨折临床愈合时间3～8个月,平均4.6个月。全部切口一期愈合,无一例发生感染,所有患者的LCP和螺钉无断裂。3例骨折术后复位丢失,5例出现钢板刺激症状。膝关节功能HSS评分60～90分,平均86.3分;踝关节功能AOFAS评分80～95分,平均90.5分;肩关节功能Neer评分80～92分,平均89.6分。结论 LCP应用于四肢粉碎性骨折,具有创伤小、对骨骼血供影响小、固定确实可靠、手术感染率低、骨折愈合快、功能恢复好等优点。然而,作为一种以全新理念设计的内固定系统,临床应用中既要充分领悟其理念,还要严格掌握其操作程序。

Treatment of the extremities comminuted fractures with locking compression plate

Objective To retrospectively evaluate the extremities comminuted fractures treated with locking compression plate(LCP).Methods 71 cases of the extremities comminuted fractures were treated with LCP.There are 39 males and 32 females,with an average age of 41.5 years(range 20-72 years).Among them 13 patients were diagnosed as distal femoral fractures,25 cases as proximal tibial fractures,6 cases as distal tibial fractures,8 cases as comminuted fractures of the shaft of the tibia,14 cases as proximal humeral f...