Zhao Wei, Cao Yang, Shi Lin-Jun, Li Tao
Zhongguo Gu Shang. 2014 Jul;27(7):597-600.
To explore treatment effect of the locking plate percutaneous external fixation to tibial fractures.
From July 2010 to February 2013, 8 cases with pediatric tibial fractures were treated by using unilateral locking plate percutaneous external fixation,including 6 males and 2 females with an average age of 7 years old ranging from 4 to 10. Among them, 5 cases were open fractures involving 1 case of Gustilo-Anderson type II, 3 cases of type III A, 1 case of type III B; and the other 3 cases were closed fractures involving 2 cases of AO type A3, 1 cases of type B2. The postoperative bone healing and gait impact were observed and the function was evaluated by Johner-Wruhs scores.
All fractures healed successfully without infection. The fracture healing time was from 3 to 6 months with an average of 3.9 months. The locking plate removal time was from 4 to 7 months with an average of 4.3 months. Among them, 7 cases were visually normal after walking with stand, 1 case of anterior tibial tendon defect affected gait. The results of Johner-Wruhs assessment were excellent in 7 cases, good in 1 case. No rub contralateral medial calf skin wounds occurenced.
The method is simple, stable and reliable. The fixation strength is suitable for children using locking plate percutaneous external fixation. The postoperative functional recovery was excellent and the walking gait was less affected. But the point of LCP pedicle screw should be carefully selected before installation with good skin coverage.
探讨锁定钢板经皮外固定治疗小儿胫骨骨折的疗效。
选取2010年7月至2013年2月收治的8例小儿胫骨骨折患者，采用单侧锁定钢板经皮外固定治疗，其中男6例，女2例，平均年龄7岁（4～10岁）。其中开放性骨折5例，包括Gustilo-AndersonⅡ型1例，ⅢA型3例，ⅢB型1例；闭合性骨折3例，包括AO A3型2例，B2型1例。观察术后骨折愈合情况及对步态的影响，采用Johner-Wruhs评分进行功能评价。
所有骨折均顺利愈合，无感染发生。骨折愈合时间3～6个月，平均3.9个月。锁定钢板取出时间4～7个月，平均4.3个月。其中7例站立行走后外观正常，1例胫前肌腱缺损影响步态。Johner-Wruhs评定结果：优7例，良1例。未发生擦破对侧小腿内侧皮肤的伤口。
该方法操作简单，固定稳定可靠，锁定钢板经皮外固定的强度适合小儿应用，术后功能恢复优良，对行走步态影响小。但应用锁定加压钢板（LCP）椎弓根螺钉时术前应仔细选择进针点，确保皮肤覆盖良好。
