应用微创经皮钢板固定技术结合解剖钢板治疗胫骨远端粉碎性骨折

目的探讨应用微创经皮钢板固定法（MIPPO）结合解剖钢板治疗胫骨远端粉碎性骨折的临床效果。方法对25例胫骨远端粉碎性骨折采用胫骨远端解剖钢板应用微创经皮钢板固定技术（MIPPO）治疗。骨折分型按AO分型A型14例，B型2例，C型9例。结果本组病例随访5～25个月，平均14个月，伤口全部愈合，其中2例延迟愈合，皆为糖尿病患者。X线片示骨痂出现时间12周，无短缩以及旋转畸形，外观无明显畸形，膝踝关节功能正常。按Johner-Wruhs胫骨骨折疗效评定标准，优19例，良4例，中2例；优良率为92％。结论MIPPO技术结合解剖钢板治疗胫骨远端粉碎性骨折具有优势，降低了手术损伤，提高治疗成功率，有利于患者肢体功能的恢复。

Minimally invasive percutaneous plate osteosynthesis and anatomical plate for fixation of distal tibial comminuted fractures

Objective To investigate the clinical effect of minimally invasive percutaneous plate osteosynthesis （ MIPPO ） and anatomical plate for fixation of distal tibial comminuted fractures. Methods Twenty-five cases of distal tibial comminuted fracture were treated with MIPPO technique. According to AO classification, there were 14 cases type A,2 type B,9 type C. Results All patients were followed up for 5 -25 months（average 14 months）. All fractures were eventually healed. Among them, the recovering of wound delayed in 2 diabetic patients. The radi- ographic healing was 14 weeks. Fracture reduction was anatomical or nearly anatomical without angular displace- ment in all cases. No patient complained of knee and ankle symptoms related to the surgery. According to Johner- Wruhs scoring system,the results were excellent in 10 cases, good in 4 and fair in 2. The excellent and good rate was 92%. Conclusion Application of minimally invasive percutaneous plate osteosynthesis with anatomical plate is a superior option for fixation of distal tibial comminnted fractures.