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微创经皮钢板固定治疗胫骨远端骨折的并发症

Complications of Minimally Invasive Percutaneous Plating for Distal Tibial Fractures.

作者信息

Muzaffar Nasir, Bhat Rafiq, Yasin Mohammad

机构信息

Hospital for Bone and Joint Surgery, Barzalla, India.

出版信息

Trauma Mon. 2016 Mar 20;21(3):e22131. doi: 10.5812/traumamon.22131. eCollection 2016 Jul.

DOI:10.5812/traumamon.22131
PMID:28182170
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5282934/
Abstract

BACKGROUND

The management of distal tibia fractures continues to remain a source of controversy and debate.

OBJECTIVES

The aim of this study was to evaluate the various complications of minimally invasive percutaneous plate osteosynthesis (MIPPO) using a locking plate for closed fractures of distal tibia in a retrospective study.

PATIENTS AND METHODS

Twenty-five patients with distal tibial fractures, treated by minimally invasive percutaneous plate osteosynthesis, were evaluated in a retrospective study. We studied the rate, probable etiological factors and preventive and corrective measures of various complications associated with minimally invasive plating of distal tibia.

RESULTS

Mean age of the patients was 41.16 years (range 22 - 65). There were 13 male and 12 female patients. All fractures united at an average duration of 16.8 weeks. There were two cases of superficial and two cases of deep infection, and deep infections required removal of hardware for cure. There were four cases of ankle stiffness, most of them occurring in intra-articular fractures, three cases of palpable implant, three cases of malunion, one case of loss of reduction and one patient required reoperation. The average AO foot and ankle score was 83.6.

CONCLUSIONS

We found MIPPO using locking plate to be a safe and effective method for the treatment of distal tibial fractures in properly selected patients yet can result in a variety of complications if proper precautions before, during and after surgery are not taken care of.

摘要

背景

胫骨远端骨折的治疗仍然是一个存在争议和辩论的来源。

目的

本研究的目的是通过一项回顾性研究,评估使用锁定钢板进行微创经皮钢板接骨术(MIPPO)治疗胫骨远端闭合性骨折的各种并发症。

患者与方法

在一项回顾性研究中,对25例接受微创经皮钢板接骨术治疗的胫骨远端骨折患者进行了评估。我们研究了与胫骨远端微创钢板固定相关的各种并发症的发生率、可能的病因以及预防和纠正措施。

结果

患者的平均年龄为41.16岁(范围22 - 65岁)。有13例男性患者和12例女性患者。所有骨折平均在16.8周时愈合。有2例表浅感染和2例深部感染,深部感染需要取出内固定物才能治愈。有4例踝关节僵硬,其中大多数发生在关节内骨折,3例可触及植入物,3例畸形愈合,1例复位丢失,1例患者需要再次手术。平均AO足踝关节评分为83.6分。

结论

我们发现,对于适当选择的患者,使用锁定钢板的MIPPO是治疗胫骨远端骨折的一种安全有效的方法,但如果在手术前、手术中和手术后没有采取适当的预防措施,可能会导致各种并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7541/5282934/c7bcf2d94f62/traumamon-21-03-22131-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7541/5282934/35d2a9593d36/traumamon-21-03-22131-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7541/5282934/182061de620c/traumamon-21-03-22131-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7541/5282934/8340d91d5a94/traumamon-21-03-22131-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7541/5282934/0689b555308b/traumamon-21-03-22131-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7541/5282934/4bf43661ca78/traumamon-21-03-22131-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7541/5282934/c7bcf2d94f62/traumamon-21-03-22131-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7541/5282934/35d2a9593d36/traumamon-21-03-22131-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7541/5282934/182061de620c/traumamon-21-03-22131-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7541/5282934/8340d91d5a94/traumamon-21-03-22131-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7541/5282934/0689b555308b/traumamon-21-03-22131-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7541/5282934/4bf43661ca78/traumamon-21-03-22131-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7541/5282934/c7bcf2d94f62/traumamon-21-03-22131-g006.jpg

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Int Orthop. 2014 Jun;38(6):1261-7. doi: 10.1007/s00264-014-2294-1. Epub 2014 Feb 19.
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Minimally invasive percutaneous plate fixation of tibia fractures: results in 80 patients.微创经皮钢板固定治疗胫骨骨折:80 例患者的结果。
Clin Orthop Relat Res. 2013 Sep;471(9):2783-9. doi: 10.1007/s11999-013-2841-x.
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Minimally invasive plate osteosynthesis of distal tibial fractures: a comparison of medial and lateral plating.
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Complications of definitive open reduction and internal fixation of pilon fractures of the distal tibia.胫骨远端 Pilon 骨折切开复位内固定的并发症。
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