Objective :To investigate the technique and chnical results of minimally invasive percutancous plate osteosynthesis (MIPPO) for the treatment of the distal fractures of tibia by an appropriate plate. Methods: From Jan. 2005 to Dec. 2007,56 patients with the distal tibia fractures were treated with MIPPO through two approaches and three types of plate involving clover plate in 35 cases,anterior L-shape anatomic plate in 12 cases,medial LCP in 9 cases. There were 38 males and 18 females with an average age of 41 years old ranging from 17 to 72 years. According to AO fracture classification for the distal tibial fractures,there were 28 cases of type A, 11 of type B, 17 type C. Results:All the patients were followed up from 12 to 24 months (averaged 16 months). All of the fractures showed bone union. The time required for the bony union ranged from 3 to 11 months (averaged 4 months). The patients were evaluated on functional recovery according to Mazur Grating System for the Ankle. The results were excellent in 51 cases, good in 5. Conclusion:Choosing effective reasonable approach and plate for the treatment of the distal tibial fractures can obtain satisfactory function, high rate of bone union and less complications.%目的:探讨根据胫骨远端骨折类型运用相应钢板微创治疗胫骨远端骨折的手术技术和临床疗效.方法:自2005年1月至2007年12月,胫骨远端骨折患者56例,其中男38例,女18例;年龄17～72岁,平均41岁.根据AO分型:A型28例,B型11例,C型17例.根据胫骨远端骨折类型,采用2个手术入路3种钢板(三叶草板35例,前侧L形解剖板12例,内侧LCP9例)对胫骨远端骨折进行内固定治疗,并行随访和功能评价.结果:56例患者获得随访,时间12～24个月,所有患者均达到骨性愈合,平均愈合时间为4个月(3～11个月).按Mazur评价标准:优51例,良5例.结论:在正确掌握手术技术的前提下,灵活选择合理钢板治疗胫骨远端骨折能够取得满意的临床疗效.
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