中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (13): 2454-2457.doi: 10.3969/j.issn.1673-8225.2011.13.041

• 骨与关节临床实践 clinical practice of the bone and joint • 上一篇    下一篇

经皮微创锁定加压钢板置入内固定治疗新鲜胫骨远端骨折32例

李国胜1,2，胡永成1   

  1. 1天津医科大学研究生院，天津市 300070
    2海洋石油总医院骨科，天津市  300452
  • 收稿日期:2011-01-08 修回日期:2011-02-08 出版日期:2011-03-26 发布日期:2013-10-23
  • 通讯作者: 胡永成，博士，主任，教授，天津市天津医院，天津市300211 yongchenghu@ yahoo,com.com.cn
  • 作者简介:李国胜★，男，1968年生，山东省宁津县人，汉族，天津医科大学在读硕士，副主任医师，主要从事骨科创伤及骨肿瘤研究。 lgswhy@yahoo. com.cn

Locking compression plate with minimally invasion percuteoneous plate osteosynthesis for 32 patients with diaphyseal and distal tibial fracture

Li Guo-sheng1, 2, Hu Yong-cheng1   

  1. 1Graduate School of Tianjin Medical University, Tianjin  300070, China
    2Department of Orthopaedics, Pelagi-petrochemical General Hospital, Tianjin  300452, China
  • Received:2011-01-08 Revised:2011-02-08 Online:2011-03-26 Published:2013-10-23
  • Contact: Hu Yong-cheng, Doctor, Professor, Graduate School of Tianjin Medical University, Tianjin 300070, China yongchenghu@ yahoo,com.com.cn
  • About author:Li Guo-sheng★, Studying for master’s degree, Associate chief physician, Graduate School of Tianjin Medical University, Tianjin 300070, China; Department of Orthopaedics, Pelagi-petrochemical General Hospital, Tianjin 300452, China lgswhy@yahoo.com.cn

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被引次数

159

摘要：

背景：传统钢板置入内固定治疗胫骨远端骨折过程中为保证骨折解剖复位，需广泛剥离骨膜直接暴露骨折端，常造成伤口愈合不良、感染和骨延迟愈合等不良后果。
目的：观察经皮微创锁定加压钢板置入内固定治疗胫骨远端骨折的效果。
方法：选择新鲜胫骨远端骨折患者32例，男26 例，女6 例，年龄18~76 岁，均采取闭合复位，小切口手术入路置入胫骨远端锁定加压钢板置入内固定治疗。置入后随访行X射线检查，采用Johner-Wruhs评分评估治疗效果。
结果与结论：30例平均随访16个月，骨折均获愈合，临床平均愈合时间14周；其中外踝手术切口浅表感染2例，皮肤刺激症状4例，螺钉断裂1例(术前X射线片无法诊断断裂)，钢板远端断裂1例，腓浅神经损伤1例。按Johner-Wruhs评分法，功能优22例，良6例，中2例，优良率为93%。说明经皮微创锁定加压钢板置入内固定治疗胫骨远端骨折创伤小、不良反应少、固定牢固、骨折愈合率高、符合生物学固定原则。

关键词: 微创, 锁定加压钢板, 胫骨远端骨折, 置入, 骨科植入物

Abstract:

BACKGROUND: To ensure anatomical reduction, traditional plate internal fixation strips extensive periosteum to expose the fracture during treatment of distal tibial fracture, resulting in adverse effects, such as infection, wound, infection and delayed bone healing.
OBJECTIVE: To evaluate the clinical effects of locking compression plate with minimally invasion percutaneous plate osteosynthesis on diaphyseal and distal tibial fracture.
METHODS: A total of 32 patients with diaphyseal and distal tibial fracture were selected, including 26 males and 6 females, aged 18-76 years. They were treated with locking compression plate with minimally invasion percuteoneous plate osteosynthesis through closed reduction and minimal incision approach. After the operation, the patients were followed-up and examined by X-ray. The treatment effects were evaluated using Johner-Wruhs score assessment.
RESULTS AND CONCLUSION: The 30 patients were followed up for 16 months. The fracture was healed, for an average healing time of 14 weeks. Two patients developed incision infection, 4 presented skin stimulation symptoms, 1 had screw breakage (Breakage was not detected by preoperative X-ray), 1 plate breakage, and 1 had superficial peroneal nerve injury. Johner-Wruhs score was excellent in 22 cases, good in 6, and fair in 2. The total excellent to good rate was 93%. Results show that locking compression plate with minimally invasion percuteoneous plate osteosynthesis in treatment of diaphyseal and distal tibial fracture leads to limited invasion, reliable fixation, low rate of complication, high rate of union, and well matches biological fixation principles.

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