Aksekili Mehmet Atif Erol, Celik Ismail, Arslan Arslan Kağan, Kalkan Tuğhan, Uğurlu Mahmut
Department of Orthopedics, Ankara Training and Research Hospital, Turkey.
Acta Orthop Traumatol Turc. 2012;46(3):161-7. doi: 10.3944/aott.2012.2597.
The aim of this study was to evaluate the time to union and complications in cases of tibial diaphysis and distal tibial fractures fixed with a minimally invasive percutaneous plate.
Thirty-five patients (23 males, 12 females) were operated on using minimally invasive percutaneous plate osteosynthesis (MIPPO) principles for tibial diaphysis and distal tibial fractures. Twenty-eight were closed and seven were open fractures. After direct or indirect fracture reduction, the plate was advanced through a submuscular extraperiosteal tunnel through the distal incision without opening the fracture line. The plate was fixed with screws through the proximal and distal incisions. Clinical and radiological evaluations were made at four to six week intervals after surgery. Full weight-bearing was allowed after an average of 14.43 (range: 12 to 20) weeks and 15.39 (range: 8 to 32) weeks in open and closed fractures, respectively. Duration of the union and complications were analyzed.
The mean duration of the union was 20.7 (range: 16 to 28) weeks and 17.96 (range: 10 to 36) weeks in open and closed fractures, respectively. All cases showed union except one who had an implant failure. Necrosis at the wound developed in one case and infection in another.
MIPPO is an effective alternative treatment for tibial diaphysis and distal tibia fractures with low complication and high union rates.
本研究旨在评估采用微创经皮钢板固定胫骨干和胫骨远端骨折时的骨愈合时间及并发症情况。
35例患者（23例男性，12例女性）接受了基于微创经皮钢板接骨术（MIPPO）原则的胫骨干和胫骨远端骨折手术。其中28例为闭合性骨折，7例为开放性骨折。在直接或间接复位骨折后，通过远端切口经肌肉下骨膜外隧道推进钢板，而不打开骨折线。通过近端和远端切口用螺钉固定钢板。术后每隔4至6周进行临床和影像学评估。开放性骨折和闭合性骨折分别在平均14.43周（范围：12至20周）和15.39周（范围：8至32周）后允许完全负重。分析骨愈合持续时间及并发症情况。
开放性骨折和闭合性骨折的平均骨愈合时间分别为20.7周（范围：16至28周）和17.96周（范围：10至36周）。除1例发生植入物失败外，所有病例均实现骨愈合。1例出现伤口坏死，另1例出现感染。
MIPPO是治疗胫骨干和胫骨远端骨折的一种有效替代方法，并发症发生率低，骨愈合率高。
