MIPPO技术治疗胫骨远端粉碎性骨折20例临床体会

目的探讨胫骨远端粉碎性骨折经MIPPO技术的临床应用及疗效。方法采用MIPPO技术治疗胫骨远端粉碎性骨折20例,统计分析手术时间、出血量、术后康复时间、骨折愈合时间等。同时对比分析外固定支架对照组15例。结果所有病例均获随访,时间5~12m,平均7.5m。1例术后8m因丹毒波及内固定物无法控制,取出内固定物后感染得到控制。根据Joher-Wruhs法评分标准：优13例,良7例,中0例,差0例,优良率100%。两组Joher-Wruhs法评分（=0.18）,无统计学意义,但治疗组术后康复时间明显缩短。结论胫骨远端的粉碎性骨折对软组织要求高,MIPPO技术可以很好的保证骨折端血供,相比较外固定术明显减少康复时间。

Clinical experience of MIPPO technique in treatment of the 20 cases of distal tibial comminuted fractures

Objective To explore the treatment of MIPPO technology in the distal tibial comminuted fractures.Method 20 patients with distal tibial comminuted fractures were treated by MIPPO technology.The operation time,bleeding volume,the rehabilitation time,fracture healing time were retrospectively analyzed.And comparatived the 20 cases on MIPPO with 15 patients by external fixation.Result All patients were followed up for the average of 7.5 months（5~12 months）.The implants was removed for erysipelas infection after 8 months postoperatively in one case.According to the criteria of Joher-Wruhs score： 13 cases were excellent,7 cases were good,the excellent and good rate was 100%.The Joher-Wruhs score between the two groups（=0.18） had no significant difference,but the rehabilitation time reduces significantly on MIPPO group.Conclusion MIPPO technique can preserve the blood supply around the fracture,and the the rehabilitation time reduces much more significantly,but the soft tissue plays an important role in the distal tibial comminuted fracture.