重建钢板和ILISS钢板治疗胫骨近段骨折的疗效比较  

Treatment of the proximal tibiai fractures with less invasive stabilization system(LISS)and reconstruction plates

作　　者：张斌[1] 吴红富[1] 刘登生[1] 查涛[1] 王松华[1] 

机构地区：[1]江苏省无锡市第三人民医院,214000

出　　处：《中国医药指南》2008年第24期73-74,共2页Guide of China Medicine

摘　　要：目的探讨重建钢板和LISS钢板治疗胫骨近段骨折的临床价值。方法2005年4月至2007年10月,采取重建钢板和LISS钢板治疗胫骨近段骨折59例,男性33例,女性26例,年龄20～71岁,平均年龄41.8岁。其中合并胫骨平台骨折51例,其中开放性骨折7例,余病例为闭合型骨折,30例采用重建钢板(结合空心螺钉)固定。结果患者均获得满意随访,随访时间4～31个月,平均14.9个月。其中3例出现表浅组织局部感染,1例因深部感染早期内固定取出改外固定支架固定、1例因创伤性关节炎而行膝关节置换术,余均无创口裂开、内固定松动、骨不连、关节僵硬及关节不稳等并发症,疗效比较HSS关节功能评定标准、负重锻炼时间、骨折愈合时间、膝关节轴线、膝关节活动范围及稳定性。结论LISS钢板利用其锁定钢板成角稳定性和抗拔出性,减少软组织的剥离,保留骨块的血供,操作简单,对波及胫骨平台的上端骨折提供了稳定的内固定、较低的创伤、较高的愈合率,这些都是普通重建钢板无法比拟的。Objective To evaluate the effect the treatment of proximal tihial fractures with A(less invasive stabilization system) and B(reconstruction plates).Methods Fifty-nine patients with proximal tibial fractures(51 tibial plateau fracture)were treated with LISS and reconstruction plates for in-fixation.The characteristics and advantages of LISS and the functions of the knee were evaluated. Results The period of following up was 4 to 31 months.3 cases had superficial wound infection and 1 case suffered deep delayed infection and changed external fixation later.Other fractures were healed without any complications.The knee HSS scores were excellent in 22cases(A);17(B),good in 6 cases(A);8(B).Conclusion The tibial LISS worked well at angle stabilization and anti-pull out in the treatment of the proximal tibial fracture with a good protection on the soft tissue and blood supply,The LISS provides stable fixation、a high rate of union and low rate of infection for proximal tibial fractures,which is much better than reconstruction plates.

关 键 词：微创内固定系统(LISS) 重建钢板 胫骨近端骨折 内固定 

分 类 号：R687.3[医药卫生—骨科学]