钳夹技术结合内侧锁定钢板内固定治疗胫骨中下段骨折  

Clamp technique combined with medial locking plate internal fixation for treatment of middle and lower tibial fractures

作　　者：陈伟 CHEN Wei(Dept of Orthopaedics and Traumatology,Chengdu Xinjin District Hospital of Traditional Chinese Medicine,Chengdu,Sichuan 611430,China)

机构地区：[1]成都市新津区中医医院骨伤科,四川成都611430

出　　处：《临床骨科杂志》2024年第5期720-723,共4页Journal of Clinical Orthopaedics

摘　　要：目的 探讨钳夹技术结合内侧锁定钢板内固定治疗胫骨中、下段骨折的疗效。方法 采用钳夹技术结合内侧锁定钢板内固定治疗34例胫骨中、下段骨折患者。记录手术情况、骨折愈合情况、关节活动度及并发症发生情况,根据Johner-Wruhs评分标准评价疗效。结果 手术时间50~80(65.10±10.15) min,术中出血量50~120(80.01±17.16) ml。患者均获得随访,时间12~16(14.2±1.3)个月。骨折均愈合,时间4~12(8.1±0.3)个月。未发生骨折延迟愈合或不愈合、皮肤坏死、钢板外露及踝关节功能明显受限等并发症。末次随访时,膝关节屈曲110°~120°,伸直-10°~10°;踝关节背伸20°~30°,跖屈40°~50°;根据胫骨骨折Johner-Wruhs评分标准评价疗效:优24例,良8例,可2例,优良率94.1%。结论 钳夹技术结合内侧锁定钢板内固定治疗胫骨中、下段骨折手术时间短,术中出血量少,骨折愈合和功能恢复良好,并发症少,疗效确切。Objective To investigate the effect of clamp technique combined with medial locking plate internal fixation in the treatment of middle and lower tibial fractures.Methods The 34 cases of middle and lower tibial fractures were treated by clamp technique combined with medial locking plate,and the surgical conditions,fracture healing status,joint range of motion and complications were recorded,the clinical effect was evaluated with Johner-Wruhs score criterion.Results The operation time was 50~80(65.10±10.15)min,the intraoperative blood loss was 50~120(80.01±17.16)ml.All patients were followed up for 12~16(14.2±1.3)months.All fractures healed in 4~12(8.1±0.3)months.There were no complications such as delayed union or nonunion,skin necrosis,exposure of broken plate and obvious limitation of ankle joint function.At the last follow-up,the knee flexion reached 110°~120°,extension reached-10°~10°;and the ankle dorsiflexion was 20°~30°,planter-flexion was 40°~50°;according to Johner-Wruhs evaluation criteria for tibial fracture,the curative effect was excellent in 24 cases,good in 8 cases and fair in 2 cases,with an excellent-good rate of 94.1%.Conclusions The treatment of middle and lower tibial fractures with the clamp technique combined with medial locking plate internal fixation have the advantages of reducing the operation time and intraoperative bleeding,good fracture healing and functional recovery,fewer postoperative complications,with definite therapeutic effect.

关 键 词：经皮钳夹法 闭合复位 内侧锁定钢板固定 胫骨骨折 

分 类 号：R683.42[医药卫生—骨科学] R687.32[医药卫生—外科学]