经皮MIPPO治疗胫骨远端骨折的临床体会及手术技巧.doc

精品论文 参考文献 经皮MIPPO治疗胫骨远端骨折的临床体会及手术技巧 （首都医科大学密云教学医院骨科 北京 101500） 【摘要】目的：总结和评价经皮MIPPO技术治疗胫骨远端骨折的临床疗效和手术技巧。方法： 2013年1月至2015年3月，应用经皮MIPPO技术治疗32例胫骨远端骨折患者，其中男性19例，女性13例；年龄21～76岁，平均47.6岁。根据AO分型：A型骨折15例，B型骨折11例，C型骨折6例。结果：本组32例患者随访时间为6～19个月，平均11个月。均达到骨性愈合。根据Johner-Wruhs评分标准，优21例，良9例，中2例，差0例，优良率为94％。结论：应用经皮MIPPO技术治疗治疗胫骨远端骨折创伤小，血运破坏少，术中出血少，内固定牢靠，骨折愈合率高，功能恢复好，符合生物力学（BO）固定原则。 【关键词】微创；内固定；胫骨；骨折； Clinical analysis and operation skill in treatment of distal tibial fractureswith minimall invasive percutaneous technique Zhang Xiao,Zhang Peng-ju,Xie Bing,Xi guo-hua,Guo Yan-feng Department of Orthopedics,The Miyun Teaching Hospital of The Capital University Sciences, Beijing,101500 China 【Abstract】ObjectiveTo summarize the surgical techniques and evaluate the results of MIPPO technique in treatment of distal tibial fracture. MethodsFrom January 2013 to March 2015,32 cases of distal tibial fractures were treated using MIPPO technique. There were 19 males and 13 females. The ages of this group ranged from 21 to 76 years old, with an average of 47.6 years. Based on the AO fracture classification system，they were divided into A in 15 patients，B in 11 patients and C in 6 patientsResults The follow-up period of the 32 cases ranged from 6 months to 19 months, the average being 11 months. Bone union was achieved in all the rest cases. According to Johner-Wruhsscoring, the excellent and good result rate was 94%. Conclusion The treatment of distal tibial fracture with the MIPPO technique has the advantages such as smaller incision， more stable fixation，higher healing rate，less tissue infection，and earlier functional exercise. Consistent with the principles of biomechanics of fixation. 【Key words】Minimally invasive；Internal fixation；Tibia;fracture 1资料与方法 1.1一般资料本组共32例患者，采用捷迈（Zimmer）公司胫骨远端内侧解剖型锁定接骨板。其中男性19 ???，女性13 例；年龄21～76 岁，平均47.6岁。根据AO分型：A型骨折15例，B型骨折11例，C型骨折6例。均为胫骨远端闭合骨折。合并其它部位骨折和损伤3例。合并后踝隐形骨折7例。急诊内固定手术5例，急诊行外固定支架临时固定9例。致伤原因：车祸11例，高处坠落伤3例，摔伤18例。 1.2术前处理 对9例高能量损