单轴与多轴锁定钢板微创治疗复杂性胫骨近端骨折  

Minimally invasive fixation of complex proximal tibial fractures by uniaxial and polyaxial locking plates

作　　者：刘建兴[1] 殷潇凡[1] 徐俊[1] 

机构地区：[1]上海瑞金医院集团闵行区中心医院骨科,上海201100

出　　处：《上海交通大学学报（医学版）》2010年第1期84-87,共4页Journal of Shanghai Jiao tong University:Medical Science

摘　　要：目的研究单轴与多轴锁定钢板微创治疗胫骨近端骨折的临床应用价值。方法回顾性分析该院2008年1月—2009年6月采用单轴锁定钢板(n=21)和多轴锁定钢板(n=17)微创治疗的复杂性胫骨近端骨折患者的临床资料,比较两组患者术后骨折愈合和功能恢复情况。结果两组38例患者均获随访,随访时间3～20个月,平均12个月。所有患者骨性愈合,单轴锁定组骨折愈合时间为10～20周,平均14周;多轴锁定组骨折愈合时间为11～18周,平均13周。按Johner-Wruhs方法评价功能,单轴锁定组优14例,良5例,可2例,差0例,优良率90.4%;多轴锁定组优11例,良5例,可1例,差0例,优良率94.1%。结论锁定钢板微创治疗胫骨近端骨折,固定可靠,创伤小,对骨骼血供影响小,骨折愈合率高,功能恢复好,是治疗复杂性胫骨近端骨折的一种有效方法。单轴锁定力学强度更高,多轴锁定可根据骨折情况调整螺钉角度,临床上可视具体情况选择应用。Objective To investigate the clinical application of minimally invasive fixation of complex proximal tibia fractures by uniaxial and polyaxial locking plates. Methods The clinical data of 38 patients with minimally invasive fixation of complex proximal tibia fractures by uniaxial （n =21） and polyaxial （n = 17） locking plates from January 2008 to June 2009 were retrospectively analysed, and the union rates and function recovery were compared between groups. Results All patients were followed up for 3 to 20 months, with an average of 12 months. All patients had bone union. The time of fracture union for fixation by uniaxial locking plates was 10 to 20 weeks, with an average of 14 weeks; and that for fixation by polyaxial locking plates was 11 to 18 weeks, with an average of 13 weeks. Evaluated by Johner-Wruhs method, there were 14 ＂excellent＂ cases, 5 ＂better＂ cases, 2 ＂good＂ cases and 0 ＂poor＂ case for fixation by uniaxial locking plates （rate of ＂excellent and better＂, 90.4%）, and there were ll ＂excellent＂ cases, 5 ＂better＂ cases, 1 ＂good＂ case and 0 ＂poor＂ case for fixation by polyaxial locking plates （rate of ＂excellent and better＂, 94. 1% ）. Conclusion Minimally invasive fixation of complex proximal tibia fractures by uniaxial and polyaxial locking plates is stable, has less effects on bone blood supply, high bone union rate and favourable function recovery, and is an effective way in the treatment of complex proximal tibia fractures. Fixation by uniaxial locking plate has a better mechanical intensity, while fixation by polyaxial locking plate can adjust the screw angle according to fracture situation, which can be clinically applied accordingly.

关 键 词：单轴锁定钢板 多轴锁定钢板 微创 胫骨近端骨折 

分 类 号：R687.3[医药卫生—骨科学]