经皮微创钢板固定技术(MIPPO)在胫骨近、远端粉碎性骨折中的应用

目的 探讨经皮微创钢板固定技术(MIPPO)治疗胫骨近、远端粉碎性骨折的方法和临床效果。方法 34例胫腓骨骨折的患者采用此方法治疗，其中男21例，女13例，年龄14～72岁。胫骨近端骨折12例，远端骨折22例。骨折按AO胫骨干分型，C1型16例，C2型10例，C3型8例。结果 本组34例随访3～26个月，平均14个月，患者伤口全部一期愈合。手术时间45～160min，平均80min，出血100～300mL，术中无输血。X线片示骨痂出现时间4～12周，平均8周，骨愈合时间4～14个月，平均6．7个月，无再骨折发生。以Johner—Wruhs方法评价功能，本组病例优21例、良11例、中2例，总体满意率94．1％。结论 经皮微创钢板固定技术创伤小、并发症少、骨愈合率高，是治疗胫腓骨近远端骨折的有效方法。

Minimally invasive percutaneous plate osteosynthesis for fractures of the metaphyseal tibia

Objective To report the technique and clinical results of minimally invasive percutaneous plate osteosynthesis (MIPPO) in treatment of fractures of the metaphyseal tibia. Methods A retrospective study was conducted to analyze 34 consecutive cases of tibiofibular fracture who had been treated with MIPPO. The average age of the patients was 38.4 years old (ranging from 14 to 72). There were 21 males and 13 females. According to AO fracture classification, there were 22 cases of type A fracture, 10 type B and 2 type C. Results Follow ups ranged from 3 months to 26 months (averaging 14 months) for the 34 cases. All the fractures reached union. The mean time of the bony union was 4 to 14 months (mean 6.7 months). The patients were evaluated with respect to functional recovery according to Johner Wruhs system. 21 cases obtained excellent results, 11 good, and 2 fair. The total satisfactory rate was 94.1%. Conclusion Minimally invasive percutaneous plate osteosynthesis (MIPPO) is a safe and effective procedure for fractures of the metaphyseal tibia with the benefits of limited invasion or soft tissue complications and high rate of bone union.