微创经皮钢板内固定术治疗胫骨远段骨折  

Treatment of Distal Tibial Fractures Using Minimally Invasive Percutaneous Plate Osteosynthesis(MIPPO)

作　　者：刘文和[1] 李康华[2] 刘芳[1] 谌思萍 付三清[1] 贺常仁 

机构地区：[1]岳阳市第二人民医院骨科,湖南岳阳414000 [2]中南大学湘雅医院骨科,湖南长沙410008

出　　处：《湘南学院学报（医学版）》2006年第3期10-12,15,共4页Journal of Xiangnan University（Medical Sciences）

摘　　要：目的探讨微创经皮钢板内固定术治疗胫骨远端骨折的疗效。方法2000年3月～2005年7月应用微创经皮钢板内固定术治疗胫骨远端骨折32例。AO分割：43A型21例（A2型12例，A3型9例），43B型7例，43C型4例。术后部分病例辅以其他外同定，术后1～2周肿胀部分消退后开始不负重关静功能锻炼。疗效及关节功能结果评定分为优、良、可、差四级。结果本组所有病例伤口一期愈合术后随访6月～2年（平均1．4年），骨折无延迟愈合，无畸形愈合，平均临床愈合时间3．2月，根据Mazur的踝荚节功能评分，优16例、良13例、可10例、差3例，优良率90．6％（29／32）。结论微创经皮钢板内固定术是治疗胫骨远端骨折的有效方法。Objective To explore using techniques of minimally invasive percutaneous plate osteosynthesis （MIPPO） for the treatment of distal tibial fractures. Methods Thirty two patients suffered from distal tibial fractures between March 2000 and July 2007 were treated by MIPPO protocol. According to the AO classification, of the 32 cases, there were. 21 cases belonging to the type of 43 A（ 12 cases of 43 A2, 9 cases of 43 A3 out of the 21 cases）, 7 cases of 43 B and 4 cases of 43 C. Part of the cases had been accompanied with proper external fixation. It would not be permit active and passive motion of ankle joint without weight - bearing until 1 ～ 2 weeks postoperative when local swelling up of the ankle and the lower limb had been faded away. The outcomes of both the treatment and the function of the ankle joint involved were graded into the excellent, the good, the fair and the poor. Results The incision of all the cases had achieved excellent healing. All the patients were followed up from 6 months to 2 years（averaged 1.4 years）. The mean time of bone union was 3.2 months. No infection, delayed union, nonunion or malunion had happened to in this series. According to Mazur ankle joint function scoring, of the 32 cases , there were 16 cases belonging to the excellent, 13 the good, 10 the fair and 3 the poor. The rate of the excellent and good was 90.6% （ 29/32 ）. Conclusion MIPPO is a safe and effective technique in the treatment of distal tibial fracture.

关 键 词：胫骨远端骨折 微创经皮钢板内固定 治疗 

分 类 号：R683.42[医药卫生—骨科学]