锁定加压钢板LCP)结合MIPPO技术治疗胫骨远端骨折的临床疗效分析.pdfVIP

提 要 目的：探讨胫骨远端骨折的手术治疗方法，提高胫骨远端骨折的治愈率。 方法：2010 年 3 月至 2011 年 4 月收治 45 例胫骨远端骨折患者，行锁定加压钢 板（LCP）结合 MIPPO 技术治疗，其中左侧 21 例，右侧 23 例，双侧 1 例，合并腓骨 骨折 30 例；男 26 例,女 19 例,年龄 17～76 岁，平均年龄 42.1 岁。术前进行软组织评 估, 明确手术时机；术中注意保护软组织，合理选择内固定物及其固定方式；术后积 极指导患者进行患肢功能康复锻炼以减少并发症的发生。临床随访 12 个月~14 个月, 平均随访时间为 12.6 个月，定期 X 线片复查，观察胫骨骨折愈合情况，并检查术后 并发症和踝关节功能活动情况。 结果：术后骨折全部骨性愈合。按：Johner-Wruhs 关节功能评定标准：术后 12 周，45 例患者优 23 例，良 12 例，可 7 例，差 3 例，优良率为 77.78% ；术后 1 年 45 例患者优 26 例，良 14 例，可 5 例，差 0 例，优良率为 88.89%。 结论：选择锁定加压钢板（LCP）结合 MIPPO 技术治疗胫骨远端骨折固定可靠稳 定，效果好，早期合理功能锻炼，降低术后并发症的发生率。 关键词 锁定加压钢板；MIPPO技术；胫骨远端骨折 The Clinical Efficacy Analysis of Combination LCP and MIPPO Surgical Treatment for Distal Tibial Fracture Speciality：Orthopaedics of TCM Author ：Xu Yi Tutor：Prof. Qi Shang feng Abstract Objective: To research surgical treatment for distal tibial fracture, improve the cure rate. Methods: Form March 2010 to April 2011, 45 cases of distal tibial fractures were treated with locking compression plate (LCP) combined with MIPPO. 21 patients were at left knees,23 were at right knees, 1 were at bilateral knees,30 concomitant fibula fractures. There were 26 cases male and 19 cases female aging from 20 to 68(mean 38.2). Preoperative evaluation of soft tissue clears the timing of surgery; in surgery, we should pay attention to the protection of the soft tissue , the reasonable choice of fixation and its fixed way; after surgery, we should guide patients to do limb function and rehabilitation exercise to reduce the incidence of complications. These patients were followed up from 12 months to 14 years with an average time 12.5 months. X-ray re-inspected regularly, observed the stations of tibial fracture healing, and che