微创经皮钢板内固定术治疗胫骨远段及Pilon骨折

目的 探讨微创经皮钢板内固定(MIPPO)术治疗胫骨远端及Pilon骨折,并对其疗效进行分析.方法 2001年3月～2004年7月应用微创经皮钢板内固定(MIPPO)术治疗胫骨远端及Pilon骨折32例.AO分型:43A型21例(A2型12例,A3型9例),43B型7例,43C型4例.术后部分病例辅以其他外固定,术后1、2周肿胀部分消退后开始不负重关节功能锻炼.疗效及关节功能结果评定分为优、良、可和差4级.结果 本组所有病例伤口一期愈合.术后随访6个月～2年(平均1.4年),骨折无延迟愈合,无畸形愈合,平均临床愈合时间3.2个月.根据Mazur的踝关节功能评分,优16例、良13例、可10例、差3例,优良率90.625%(29/32).结论 微创经皮钢板内固定(MIPPO)术是治疗胫骨远端骨折及Pilon骨折的有效方法.

Treatment of distal tibial fractures and Pilon fractures using minimally invasive percutaneous plate osteosynthesis (MIPPO)

[Objective] To explore retrospectively the techniques of minimally invasive percutaneous plate osteosynthesis(MIPPO)for the treatment of distal tibial fractures or Pilon fractures and analyze the outcomes of the treatment.[Methods] Thirty two patients suffered from distal tibial fractures or Pilon fractures between March 2001 and July 2004 were treated by minimally invasive percutaneous plate osteosynthesis(MIPPO)protocol.According to the AO classification,of the 32 cases,there were 21 cases belonging to the type of 43 A(12 cases belonging to the type of 43 A2,9 cases belonging to the type of 43 A3 out of the 21 cases),7 cases belonging to the type of 43 B and 4 cases belonging to the type of 43 C.Part of the cases had been accompanied with proper external fixation.It would not be permit active and passive motion of ankle joint without weight-bearing until 1~2 weeks postoperative when local swelling up of the ankle and the lower limb had been faded away.The outcomes of both the treatment and the function of the ankle joint involved were graded into the excellent,the good,the fair and the poor.[Results] The incision of all the cases had achieved excellent healing.All the patients were followed up from 6 months to 2 years(averaged 1.4 years).The mean time of bone union was 3.2 months.No infection,delayed union,nonunion or malunion had happened to in this series.According to Mazur ankle joint function scoring,of the 32 cases,there were 16 cases belonging to the excellent,13 the good,10 the fair and 3 the poor.The rate of the excellent and the good was 90.625%(29/32).[Conclusion] MIPPO is a safe and effective technique in the treatment of distal tibial fracture or Pilon fractures.