锁定钢板系统在四肢骨折中的应用  

Application of minimally invasive locking plate in the treatment of extremities fractures

作　　者：姜为民[1] 周峰[1] 史金辉[1] 杨惠林[1] 唐天驷[1] 

机构地区：[1]苏州大学附属第一医院骨科, 苏州215006

出　　处：《中华骨科杂志》2008年第4期270-273,共4页Chinese Journal of Orthopaedics

摘　　要：目的总结微创锁定钢板治疗四肢骨折的疗效。方法2005年5月至2006年10月，分别采用微创内固定系统（less invasive stabilization system，LISS）与锁定加压钢板（locking compression plate，LCP）对64例70处四肢骨折进行治疗，男45例，女19例；年龄17-69岁，平均36．8岁；股骨远端骨折16例19处，胫骨近端骨折28例31处，胫骨远端骨折8例8处，肱骨近端骨折12例12处。50处股骨远端与胫骨近端骨折采用L1SS固定，20处胫骨远端与肱骨近端骨折采用LCP固定。在影像增强器监视下先行闭合复位，复位满意后采用经皮微创接骨术于肌肉下骨膜外置入LISS或LCP，再次确认位置满意后通过导向器经皮拧入锁定螺钉。结果随访时间4～22个月，平均8．8个月。全部伤口均一期愈合，无一例发生感染、骨折再移位、成角畸形或内固定失败等并发症。骨折临床愈合时间8～16周，平均12．3周。膝关节功能HSS评分70-95分，平均87．5分，ROM90°-130°，平均122°；踝关节AOFAS评分82-95分，平均91．4分；肩关节功能Neer评分82-94分，平均90．6分。患肢功能均恢复良好。结论微创技术结合锁定钢板治疗四肢骨折具有软组织创伤小、对骨骼血供影响小、骨折愈合快、手术感染率低、功能恢复好等优点。锁定钢板无须紧贴骨面即可获得可靠的固定，不易发生骨折再移位或内固定松动。Objective To observe the application of minimally invasive locking plate in the treatment of the extremities fractures. Methods Sixty-four cases （70 fractures） of the extremities fractures were treated with less invasive stabilization system （LISS） or locking compression plate（LCP） by minimally invasive techniques from May 2005 to October 2006. There are 45 males and 19 females, with average age of 36.8 years （range 17-69 years）. This study included 16 patients with 19 distal femoral fractures, 28 patients with 31 proximal tibal fractures, 8 patients with 8 distal tibal fractures, 12 patients with 12 proximal humeral fractures. 50 distal femoral or proximal tibial fractures were treated with LISS, while 20 distal tibial or proximal humeral fractures were treated with LCP. Close reduction was performed under the image intensifier. LISS or LCP were fixed by the minimally invasive percutaneous osteosynthesis （MIPO） technique. Clinical and radiological assessment was performed during the period of follow-up. Results All patients have been followed up for 4-22 months with an average of 8.8 months. All wounds were healed at the primary stage. Fracture healing was defined as radiological evidence of bridging mature callus combined with pain-free full weight bearing. No infection, no displacement, no angulation or failure of internal fixation took place. There were no cases of non-union,delyed-union and malunion. The fracture healing time was 8-16 weeks with an average of 12.3 weeks. The mean HSS score for knee joint was 87.5, AOFAS score for ankle joint was 91.4, and Neer score for shoulder joint was 90.6 postoperatively, The function of all the extremities restored well, Conclusion Comparing the conventional compression plate, it has many obvious advantages using locking plate with MIPO techniques in the treatment of the extremities fractures： less soft tissue trauma, less damage to the blood vessel of the bone, rapid union, lower infection rate and satisfactory function recovery. It can get relia

关 键 词：骨折 骨折固定术 内 内固定器 

分 类 号：R687.3[医药卫生—骨科学]