微创经皮锁定钢板内固定治疗胫骨平台骨折的效果分析

目的探讨实用微创经皮锁定钢板内固定术（MIPPO）在治疗胫骨平台骨折中的效果。方法MIP—PO治疗胫骨平台59例，其中男34例，女25例，年龄17～78岁，平均37．9岁。其中闭合伤46例，开放性损伤13例。按Schatzker分类方法：I型12例，Ⅱ型21例，Ⅲ型15例，Ⅳ型11例。术中骨折处塌陷严重者行植骨。结果所有59例患者均获得有效随访，平均随访时间18．6个月。骨折愈合平均时间3．2个月，无延迟愈合、不愈合、内固定松动及畸形愈合，最终随访采用Lysholm膝关节功能评分，优43例，良11侧，可5例，总优良率为91．5％。结论MIPP0结合锁定钢板在治疗胫骨平台骨折中具有创伤小、固定牢固、感染率低、并发症少、骨折愈合率高、可早期功能锻炼等优点，值得临床推广应用。

Treatment of tibiai plateau fracture by minimally invasive percutaneous plate osteosynthesis

Objective To summarize the clinical effect of minimally invasive percutaneous plate osteosynthesis （MIPPO） for the treatment of tibial plateau fracture with locking plate. Methods A total of 59 cases were operated via MIPPO,34 cases were male, 25 cases were female, aged 17--78, and averaged 37.9. Forty-six cases got closed fracture and 13 cases open fracture. According to Schatzker classification, 12 cases were type I , 21 cases type Ⅱ , 15 cases type Ⅲ ,and Ⅱ cases type IV. Patients who had a severe plateau collapse received a bone grafting. Results Fif- ty-nine cases were available with a mean of 18.6 months follow-up. All cases got a bone union recover within aver- aged 3.2 months, with no delayed union, nonunion, loosening internal fixation, and union in deformity developed post- operatively. According to Lysholm numerical rating system,43 patients showed an excellent result and 11 cases satis- factory,accounted for 91.5%. Conclusion The treatment of MIPPO for the tibial plateau fracture with locking plate could get a good clinical result, such as less damage, solid fixation,less infection, and less complications postoperative- ly ,which deserve clinical expansion.