锁定钢板经皮桥接复位固定治疗管状骨骨折  

Treatment of fracture of the tubiform bone with domestic locking plate through minimal invasive incision and bridging reduction fixation

作　　者：姜滔[1] 王昌兴[1] 沈建国[1] 

机构地区：[1]浙江中医药大学附属第二医院,浙江杭州310005

出　　处：《中国骨伤》2008年第1期52-53,共2页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨国产锁定钢板经皮桥接固定四肢管状骨骨折的方法以及疗效。方法:40例四肢管状骨骨折患者,男29例,女11例;年龄20～69岁,平均38.27岁。闭合性骨折34例,按AO/ASIF分型:A型7例,B型10例,C型17例;开放性骨折6例,按Gustilo分类:Ⅰ型2例,Ⅱ型4例。采用小切口锁定钢板插入,对骨折进行手法复位后,利用锁定钢板结合直径3.5mm克氏针来维持手法复位后的位置,同时通过C形臂X线调整骨折位置,最后通过桥接固定的方式固定。结果:40例患者均获随访,平均6个月(4～10个月)。骨折愈合时间3～8个月,平均4.6个月。按Ovadia标准,优16例,良20例,可3例,差1例,优良率90%。结论:国产锁定钢板经皮桥接固定具有固定可靠、价格低廉的优点,能达到进口锁定钢板微创治疗的效果,特别适用于骨质疏松以及粉碎性骨折的患者。Objective：To study the therapeutic method and clinical effect of domestic locking plate for treating fracture of the tnbiform bone through a minimal incision and bridging fixation. Methods：Among 40 patients with fracture of the tubiform bone,29 patients were male and 11 patients were female,aged from 29 to 69 years,with the average of 38.27 years. Among 34 patients with closed fracture,7 cases were type A, 10 cases type B, 17 cases type C according to AO/ASIF classification. Among 6 patients with open fracture,2 cases were type Ⅰ ,4 cases were type Ⅱ according to Gustilo classification. These patients were treated with a small incision ＇after manipulative reduction. Locking plate and 3.5 mm diameter Kirschner wire were used to maintain the reduction and through the C-arm X-ray machine to check and adjust the position ,screw were locked to bridging fixation at last. Results： Forty cases were followed up in 6 months on average（ranging from 4 to 10 months）. The average time of union of fracture was 4.6 months（ ranging from 3 to 8 months）. According to Ovadia typing,the results were excellent in 16 cases,good in 20 cases,fair in 3 cases,poor in 1 case. The excellent and good rate was 90%. Conclusions：The domestic locking plate is suitable for patients with osteoporosis and comminuted fracture because of the advantages of reliable fixation and low price. It could achieve the same effect of minimal invasive as LISS （less invasive stabilizing system） plate through the improvement of operative method.

关 键 词：锁定钢板 微创 桥接 手术方式 

分 类 号：R683.4[医药卫生—骨科学] R687.3[医药卫生—外科学]