经皮钢板固定技术在胫骨远端骨折中的应用

目的：探讨经皮微创钢板固定技术（MIPPO）治疗胫骨远端骨折的方法和临床效果。方法：采用MIPPO治疗65例胫骨远端骨折的患者，其中男42例，女23例；年龄13-75岁。按AO胫腓骨远端骨折分型：A1型5例．A2型22例，A3型32例，C1型6例。结果：本组随访6—18个月，平均11个月，Ⅰ期愈合59例，胫骨远端切口感染6例。手术时间45-90min，术中无输血，出血约100ml。X线片示骨痂出现时间4-12周，平均8周。骨愈合时间3-6个月．平均4-5个月，无再骨折发生。根据Mazur踝关节评分系统评价功能：优40例，良19例，中6例，差0例。以优良为满意标准，满意率90．7％。结论：经皮微创钢板固定技术创伤小、并发症少、骨愈合率高，是治疗胫骨远端骨折的最佳选择之一.

Technology of minimally invasive percutancous plate osteosynthesis for the treatment of fractures of the distal tibia

Objective: To explore the technique and clinical results of minimally invasive percutancous plate osteosynthesis(MIPPO)for the treatment of fractures of the distal tibia. Methods: A retrospective study was conducted to analyze 65 patients with the distal tibia fractures who had been treated with MIPPO. The average age of the patients was 35 years old (ranging from 13 to 75). There were 42 males and 23 females. According to AO fracture classification for the distal tibial fractures,there were 5 cases of type-A1 fracture,22 type-A2,32 type-A3 and 6 type-C1. Results: All the patients were followed up and ranged from 6 to 18 months(averaged 11 months). All the fractures showed union. The time required for the bony union ranged from 3 to 6 months(averaged 4.5 months). The patients were evaluated with respect to functional recovery according to Mazur Grating System for the Ankle. Forty patients obtained excellent results,19 good and 6 fair. The total satisfactory rate was 90.7%. Conclusion: The technology of minimally invasive percutancous plate osteosynthesis(MIPPO)is a safe and effective procedure for the distal tibial fractures with the benefits of limited invasion,less complications and high rate of bone union.