Leung Frankie K L, Law T W
Department of Orthopaedics and Traumatology, University of Hongkong, Hongkong, PR China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2009 Nov;23(11):1323-5.
To evaluate the application of minimally invasive plate osteosynthesis (MIPO) technique in treatment of distal tibia fractures with locking compression plate (LCP).
From August 2002 to August 2007, 62 subjects were recruited (36 males and 26 females) at mean age of 44 years old (range, 21-87 years old). According to AO classification, there were 8 cases of type A1, 15 cases of type A2, 9 cases of type A3, 7 cases of type B3, 11 cases of type C1, and 12 cases of type C2. Of them, 52 patients had closed fractures and 10 had open fractures. Ten open fractures included 6 Grade I fracture and 4 Grade II fracture. The time from injury to operation was 8 hours to 6 days. The X-ray films were taken after 3 months of operation.
Near anatomical reduction was achieved in 56 fractures and acceptable reduction in 6 fractures. Mean operation time was 43 minutes (range, 37-120 minutes). Primary healing of surgical wounds was observed in all cases. Subjects were followed up for 23 months on average (ranged, 18-45 months). All fractures healed with a mean healing time of 19.5 weeks (range, 16-32 weeks). According to Teens and Wiss ankle scoring system, 30 patients got excellent results, 25 good, and 7 fair; and the excellent and good rate was 88.7% at 12-month follow-up. There were 7 cases of delayed soft tissue infection which needed implant removal. There was one complication of compartment syndrome which required fasciotomy. There was one case with loss of reduction (valgus tilting of tibial plafond) that required bone grafting.
The results of MIPO LCP in treatment of distal tibia fractures were satisfactory. This technique was safe with no incidence of serious complications.
评估微创钢板接骨术（MIPO）技术结合锁定加压钢板（LCP）治疗胫骨远端骨折的应用效果。
2002年8月至2007年8月，招募62例患者（男36例，女26例），平均年龄44岁（范围21 - 87岁）。根据AO分类，A1型8例，A2型15例，A3型9例，B3型7例，C1型11例，C2型12例。其中闭合性骨折52例，开放性骨折10例。10例开放性骨折中，Ⅰ级骨折6例，Ⅱ级骨折4例。受伤至手术时间为8小时至6天。术后3个月拍摄X线片。
56例骨折达到近解剖复位，6例达到可接受复位。平均手术时间为43分钟（范围37 - 120分钟）。所有病例手术切口均一期愈合。患者平均随访23个月（范围18 - 45个月）。所有骨折均愈合，平均愈合时间为19.5周（范围16 - 32周）。根据Teens和Wiss踝关节评分系统，随访12个月时，优30例，良25例，可7例；优良率为88.7%。发生7例软组织感染延迟，需取出内固定物。发生1例骨筋膜室综合征并发症，需行筋膜切开减压术。发生1例复位丢失（胫骨平台外翻倾斜），需行植骨术。
MIPO技术结合LCP治疗胫骨远端骨折效果满意。该技术安全，无严重并发症发生。
