| 微创经皮钢板内固定技术结合前外侧单一切口入路治疗开放性胫腓骨远端骨折 |
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投稿时间：2020-01-06
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| 作者 | Author | 单位 | Address | E-Mail |
| 胡旭峰 |
HU Xu-feng |
皖南医学院第一附属医院弋矶山医院 创伤骨科, 安徽 芜湖 241001 |
Department of Traumatic Orthopaedics, the First Affiliated Hospital of Wannan Medical College, Wuhu 241001, Hubei, China |
huxufeng108@163.com |
| 杨民 |
YANG Min |
皖南医学院第一附属医院弋矶山医院 创伤骨科, 安徽 芜湖 241001 |
Department of Traumatic Orthopaedics, the First Affiliated Hospital of Wannan Medical College, Wuhu 241001, Hubei, China |
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| 丁国正 |
DING Guo-zheng |
皖南医学院第一附属医院弋矶山医院 创伤骨科, 安徽 芜湖 241001 |
Department of Traumatic Orthopaedics, the First Affiliated Hospital of Wannan Medical College, Wuhu 241001, Hubei, China |
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| 周茂生 |
ZHOU Mao-sheng |
皖南医学院第一附属医院弋矶山医院 创伤骨科, 安徽 芜湖 241001 |
Department of Traumatic Orthopaedics, the First Affiliated Hospital of Wannan Medical College, Wuhu 241001, Hubei, China |
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| 袁建敏 |
YUAN Jian-min |
皖南医学院第一附属医院弋矶山医院 创伤骨科, 安徽 芜湖 241001 |
Department of Traumatic Orthopaedics, the First Affiliated Hospital of Wannan Medical College, Wuhu 241001, Hubei, China |
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| 期刊信息：《中国骨伤》2020年，第33卷，第10期，第970-974页 |
| DOI：10.12200/j.issn.1003-0034.2020.10.016 |
| 基金项目: |
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中文摘要:
目的：探讨经皮微创钢板内固定（minimally invasive percutaneous plate osteosynthesis，MIPPO）技术结合前外侧单一切口入路Ⅰ期治疗胫腓骨远端开放性骨折的临床疗效。
方法：自2015年3月至2019年2月对10例开放性胫腓骨远端骨折患者行单一前外侧切口结合MIPPO技术治疗，其中男8例，女2例；年龄31～68岁。开放性骨折根据Gustilo分型，Ⅰ型6例，Ⅱ型3例，ⅢA1例。观察患者的手术时间、术中出血量、骨折愈合情况，采用Mazur踝关节功能评分进行临床疗效评价。
结果：10例患者均获得随访，时间9～24个月。手术时间85～120 min，术中出血量80～200 ml，骨折愈合时间18～30周。9例Gustilo分型为Ⅰ、Ⅱ型患者伤口均取得满意愈合，1例Gustilo ⅢA期患者原创口愈合差，给予Ⅱ期皮瓣移植取得愈合，所有患者无钢板外露及感染发生。末次随访时根据Mazur踝关节评分，总分61～97分，其中优8例，良1例，差1例。
结论：MIPPO技术结合小腿前方单一前外侧切口治疗胫腓骨远端开放性骨折，术中保护原内侧切口，通过前外侧伸肌群覆盖内固定物避免钢板外露，MIPPO技术微创操作保护骨折端血供提高骨折端愈合率，是一种可选择的手术方式。 |
| 【关键词】微创外科手术 手术切口 胫骨 腓骨 骨折 |
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| Minimally invasive percutaneous plate internal fixation through anterolateral single incision for the treatment of open distal tibiofibula fractures |
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ABSTRACT
Objective: To investigate therapeutic effect of minimally invasive percutaneous plate internal fixation (MIPPO) through a single incision in treating open distal tibiofibula fractures.
Methods: From March 2015 to February 2019,10 patients with open distal tibiofibula fractures were treated with MIPPO technique through single anterolateral incision,including 8 males and 2 females,aged from 31 to 68 years old. According to Gustilo classification,6 patients were typeⅠ,3 patients were typeⅡand 1 patient was type ⅢA. Operative time,intraoperative blood loss and fracture healing were observed,Mazur ankle joint scoring was used to evaluate clinical effect.
Results: All patients were followed up from 9 to 24 months. Operative time ranged from 85 to 120 min,intraoperative blood loss ranged from 80 to 200 ml,fracture healing time ranged from 18 to 30 weeks. Nine patients with Gustilo typeⅠandⅡachieved satisfactory healing wound,original wound of 1 patient with Gustilo type ⅢA was poor,and healed by skin flap transplantation at stageⅡ. No steel exposed and infection occurred. According to Mazur ankle scoring at the final following-up,total score was from 61 to 97,and 8 patients got excellent result,1 good and 1 poor.
Conclusion: MIPPO technique through anterolateral single incision for the treatment of open distal tibiofibula fractures could protect original medial wound in opertaion,avoid plate exposed through anterolateral extensor tendon to cover internal fixation,and MIPPO technique could protect fracture end blood flow to improve fracture healing rate,and it is a kind of choice. |
| KEY WORDS Minimal surgical procedures Surgical incision Tibia Fibula Fractures |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 胡旭峰,杨民,丁国正,周茂生,袁建敏.微创经皮钢板内固定技术结合前外侧单一切口入路治疗开放性胫腓骨远端骨折[J].中国骨伤,2020,33(10):970~974 |
| 英文格式: | HU Xu-feng,YANG Min,DING Guo-zheng,ZHOU Mao-sheng,YUAN Jian-min.Minimally invasive percutaneous plate internal fixation through anterolateral single incision for the treatment of open distal tibiofibula fractures[J].zhongguo gu shang / China J Orthop Trauma ,2020,33(10):970~974 |
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