微创经皮钢板置入内固定治疗胫腓骨骨折的技术操作特点  

Surgical features of minimally invasive percutaneous plate osteosynthesis in treating tibial and fibular fractures

作　　者：徐海波[1] 张普晟[1] 王洪兵[1] 

机构地区：[1]济宁医学院附属金乡医院,山东省金乡县272200

出　　处：《中国组织工程研究与临床康复》2007年第32期6481-6483,共3页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：目的:总结微创经皮钢板置入内固定治疗胫腓骨骨折的技术操作特点,并观察材料及宿主反应。方法:2004-06/2006-10在济宁医学院附属金乡医院对18例胫腓骨骨折患者在微创手术下进行了手术置入内固定材料。男13例,女5例,年龄17～73岁。术后按Johner-Wruhs方法评价测试各大关节功能,分为优、良、中、差。全部病例进行临床随访。术前、术后1周、6周、3个月、半年及1年分别摄X线片与健侧对比测量患肢外观、成角、旋转和短缩情况,并观察材料及宿主反应。结果:①本组病例切口均顺利愈合,术后3～14d出院。②全部获得随访,平均随访时间14个月;骨愈合时间3～10个月。③按Johner-Wruhs方法评价功能,优13例,良4例,中1例,差0例,以优良为满意标准,本组病例总体满意率94.4%。④术后1例出现跛行步态,中度疼痛,骨成角畸形15°,可能因为患者对不锈钢材料有排斥反应造成固定不牢所致。结论:微创经皮钢板置入内固定材料治疗胫腓骨骨折具有手术创伤小、骨折愈合快、功能恢复好的特点;内固定材料未出现特殊材料反应与宿主反应。AIM：To explore the technical features of minimally invasive percutaneous plate osteosynthesis （MIPPO） in treating tibial and fibular fractures and observe the material and host responses. METHODS： Eighteen patients with tibial and fibular fracture including 13 males and 5 females, aged 17-73 years, who underwent MIPPO from June 2004 to October 2006, were selected from Jinxiang People＇s Hospital of Jining Medical College. The joint function was evaluated by Johner-Wruhs method, and graded by excellent, good, moderate, and bad. All the patients were followed up after operation. The appearance, aegulation, rotation and crispation of affected limbs were detected by X-ray before, 1, 6 weeks, 3 and 6 months after operation to compare with the normal side. Meanwhile, the material and host reaction were observed. RESULTS： ①All cases achieved primary healing and discharged within 3 to 14 days after operation. ②Postoperatively follow-up for 14 months by average showed that all cases of synostosis healed within 3 to 10 months. ③Accerding to Johner-Wruhs criteria, the results of the treatment were evaluated as excellent in 13 cases, good in 4, moderate in 1, and bad in 0. The total ratio of satisfaction was 94.4%.④One case was found dropping with moderate pain and 15° bone angulation abnormity, which may be caused by the unstable fixation due to the rejection to the stainless steel material. CONCLUSION： Treatment of tibial and fibular fractures with MIPPO and various kinds of plate has the advantages of less trauma, rapid fracture healing and good recovery of function. Moreover, no specific material or host respionse is found in the internal fixation material.

关 键 词：微创 钢板 内固定 胫腓骨骨折 

分 类 号：R687[医药卫生—骨科学]