微创经皮锁定加压钢板内固定治疗胫骨中下段骨折的临床疗效观察.pdfVIP

提 要 目的：探讨微创经皮锁定加压钢板内固定术在治疗胫骨中下段骨折中的临床疗效 及相关方法。 方法：本研究病例来自山东中医药大学附属医院骨科病房自2009年8月至 2011 年6月收治的34例胫骨中下段骨折患者。其中男20例，女14例，年龄18～73岁， 平均 46 岁。损伤原因：交通车祸伤 20 例，重物压砸伤 9 例，摔伤 5 例。胫骨干 AO 分型：A 型 6 例，B 型 22 例，C 型 6 例。开放性骨折 Gustilo 分型：I 型 2 例。术前 结合临床与影像学资料对患者病情进行评定，加强对患者患肢软组织损伤情况的重 视，确定合适的手术时机。短期内无法进行手术的患者，均予抬高患肢，并行跟骨牵 引。术中注意对刀口的选择及对软组织的保护。术后及时的指导患者进行系统的康复 训练，并采取必要的措施防止并发症的发生。术后九个月按 Johner-Wruhs 胫骨干骨 折最终结果评定方法进行功能评价，观察疗效。 结果：34例患者，优28例，良3例，中3例，差0例，优良率91.2%。 结论：微创经皮锁定加压钢板在治疗胫骨中下段骨折中具有适应性广、术中创伤 小、术后骨折愈合快、并发症少及肢体功能恢复好等特点，取得了满意的临床疗效。 关键词 微创 LCP钢板 胫骨中下段骨折 临床疗效观察 Minimally invasive percutaneous plate osteosynthesis (MIPPO)with the locking compression plate system(LCP) treatment the tibia fracture of below the middle clinical curative effect observation Speciality: Orthopaedics of TCM Author: Fu Lin Tutor: Prof. Xie Jin Abstract Objective: Discuss MIPPO with LCP in the treatment of the tibia fracture of below the middle for clinical curative effect and related methods. Methods: This study from Shandong university of Chinese medicine cases affiliated hospitals orthopedic ward from August 2009 to June 2011, 34 patients of the tibia fracture of below the middle. Among them male 20, female 14, average age 46 (18 to 73 year).The traffic accident injury 20 cases, clog 9 cases, fall 5 cases. Ao classification: A type in 6 cases, B type in 22 cases, C type in 6 cases. Open fractures Gustilo points classification: type I in 2 cases. Preoperative combined with clinical and imaging material to assess symptoms in patients, especially the soft tissue, determine the right operation time. The short term unable to surgery patients, all to drive up limb, parallel traction with bone. Intraoperative pay attention to the choice of the bl