闭合手法整复微创钢板内固定治疗胫骨中下段骨折临床观察  

Close reduction by Chinese traditional manipulation and MIPPO for the treatment of tibial fractures in middle and distal segment

作　　者：刘显东[1] 王小兵[1] 巫宗德 张宇[1] 徐强[1] 郑金文[1] 陈星宇[1] 

机构地区：[1]四川省骨科医院,四川成都610041

出　　处：《中国骨伤》2012年第7期566-568,共3页China Journal of Orthopaedics and Traumatology

摘　　要：目的:研究闭合手法整复微创钢板内固定治疗胫骨中下段骨折的临床技术和疗效。方法:自2005年1月至2009年12月,40例胫骨中下段骨折患者,男28例,女12例;年龄21～76岁,平均54岁。根据AO分型:A型26例,B型8例,C型6例。根据胫骨中下段骨折类型,采用手法闭合整复小切口经皮钢板内固定对胫骨中下段骨折进行治疗。结果:40例获得随访,时间12～24个月,平均18个月。所有患者达到骨性愈合,平均愈合时间4个月(3～18个月)。按Mazur评价标准:总分为(96.67±3.91)分,其中疼痛(48.59±2.28)分,徒步上山(2.95±0.22)分,徒步下山(2.85±0.37)分,下楼梯(2.92±0.35)分,跑步(4.95±0.32)分,踝关节跖屈(4.62±0.54)分,踝关节背伸(4.13±0.61)分;优36例,良3例,中1例。结论:运用手法闭合整复骨折联合微创钢板固定胫骨中下段骨折,能更好地保护骨折部位的血供,同时取得更加微创条件下的可靠骨折固定,最终获得满意的临床结果。Objective：To explore the technique and clinical results of close manipulative reduction and minimally inva- sive percutancous plate osteosynthesis （MIPPO） for the treatment of tibial fractures in the middle and distal segment. Meth- ods： From Jan. 2005 to Dec. 2009,40 patients with tibia1 fractures in middle and distal segment were treated with close ma- nipulative reduction and MIPPO fixation ,including 28 males and 12 females with an average age of 54 years old （ranging from 21 to 76）. According to AO fractures classification for the tibial fractures in the middle and distal segment, there were 26 cases of type A, 8 of type B, 6 of type C. Results：All patients were followed up for 12 to 24 months （averaged 18 months ）. All the fractures gained bone healing,and the time required for the bony union ranged from 3 to 18 months （averaged 4 months）. The patients were evaluated with respect to functional recovery according to Mazur Grating System for the ankle. The aggregate score was 96.67±3.91, involving pain 48.59 ±2.28, hills up 2.95±0.22, hills down 2.85 ±0.37, stairs down 2.92±0.35, run score 4.95±0.32, plantar flexion score 4.62±0.54, dorsiflexion score 4.13±0.61. The clinical results were excellent in 36 cases, good in 3 and fair in 1. Conclusion： Close manipulative reduction and MIPPO fixation is a good method for the treatment of the tibial fractures in the middle and distal segment.

关 键 词：胫骨骨折 手法 骨科 骨折内固术 内 外科手术 

分 类 号：R683.42[医药卫生—骨科学]