透视下手法复位经皮解剖型锁定钢板固定治疗胫骨中下段骨折  

Application of Fluoroscopy Manipulative Reduction and Fixation with Anatomic Locking Plate for the Lower Segment Fractures of the Tibia

作　　者：林国叶[1] 刘航涛[1] 黄玉栋[1] 李平生[1] 

机构地区：[1]南京军区福州总医院九五临床部,福建莆田351100

出　　处：《医学综述》2013年第19期3637-3639,共3页Medical Recapitulate

摘　　要：目的 探讨采用透视下手法复位、经皮解剖型锁定钢板内固定治疗胫骨中下段骨折的疗效.方法 自2008年7月至2012年6月南京军区福州总医院九五临床部对胫骨中下段骨折56例采用透视下手法复位、经皮解剖型锁定钢板内固定治疗,通过内踝5 cm长纵切口,在胫骨内侧骨折两端于骨膜外建立皮下隧道,解剖型锁定钢板经此隧道插入,通过两端少数螺钉固定于胫骨内侧.伴有腓骨下段骨折可行腓骨下段切开复位钢板内固定.结果 平均手术时间为（58.0±0.5） min,无明显的术中和术后并发症,平均住院时间为（9.1±0.2） d.随访4 ～18个月,所有病例切口均甲级愈合,固定可靠,未见断钉、断板与松动现象,无骨折延迟愈合及不愈合.结论 通过透视下手法复位、经皮解剖型锁定钢板内固定治疗胫骨中下段骨折,具有创伤小、手术时间短、复位固定确实可靠、并发症少等优点,是治疗胫骨中下段骨折的有效方法.Objective To explore the use of fluoroscopy manipulative reduction and fixation with ana- tomic locking plate for the lower segment fractures of the tibia. Methods From July 2008 to June 2012 in the 95th Clinical Department of Fuzhou General Hospital of PLA ,56 cases of the lower segment fractures of the tibia were treated with fluoroscopy manipulative reduction and fixation using anatomic locking plate. 5cm long vertical incision was done at medial malleolus, from which a subcutaneous tunnel outside the periosteum could be created through the medial tibial fractures. Anatomic locking plate was inserted through this tunnel and fixed at the medial tibial using a few screws. In case of associated with fibula fracture, open reduction and internal fixation could be done at the same time. Results The mean operative time was （ 58.0 -＋ 0.5 ） minutes,with no obvious intraoperative and postoperative complications（9. 1 ＋ O. 2）days was the average length of stay. Followed up for 4-18 months,all cases＇ incision were healed at the first grade. All cases were fixed reliably, with no broken nails, no broken boards and loosening phenomenon, no delayed union and nonunion. Conclusion Fluoroscopy manipulative reduction and fixation with anatomic locking plate for the lower segment fractures of the tibia has the advantage of less traumal, shorter operative time, reliable reduction and fixation, and fewer complications, which is an effective method for treating the lower segment fractures of the tibia.

关 键 词：胫骨中下段骨折 手法复位 经皮技术 解剖型锁定钢板 

分 类 号：R641[医药卫生—外科学]