Orthopedic Trauma Division, Trauma Center, Gachon University College of Medicine, Namdong-gu, Incheon, Republic of Korea.
Department of Orthopaedic Surgery, Kyungpook National University Hospital, Chung-gu, Daegu, Republic of Korea.
Injury. 2020 Apr;51(4):878-886. doi: 10.1016/j.injury.2020.02.044. Epub 2020 Feb 11.
Miniplates were initially developed as targets for foot and hand fractures, but they have been used in the treatment of fixation of small bone fragments, reduction of long bone fractures and non-union treatment, which have been difficult to treat. In this study, the authors used miniplates to treat fractures of the upper extremities, lower extremities, and pelvis obtained good outcomes. Herein, the authors report these good outcomes and review the current concept of miniplates.
Forty-two patients treated with miniplates between March 2012 and March 2017 who attended follow-up for > 1 year were included in this retrospective study. Miniplates were selected according to purpose, which was classified into three categories: fixation, reduction, and stability enhancement. For fixation, miniplates were used to fix distal fibular fractures occurring distal to the syndesmosis and treat patellar and olecranon fractures with severe comminution. For reduction, miniplates were used to reduce the tibia during intramedullary nailing in tibiofibular shaft fractures, while reduction was performed in advance of definitive plating fixation in patients with humeral and pelvic fractures. To enhance stability, the miniplate was inserted after autobone graft for atrophic nonunion at the humeral shaft following nail insertion. The validity of a miniplate was analyzed by reviewing the published literature on the use of miniplates in orthopedic fracture surgeries.
Bony union was achieved in all cases. No specific postoperative complications were observed; however, mild pain and limited range of motion observed in two patients were resolved after implant removal. Sixteen studies on fracture treatment using miniplates reported clinically fair outcomes.
Miniplates are not just small metal plates. Depending on the location and treatment of the fracture, the miniplate can effectively fix small bone fragments, help the main plate to maintain the reduction of large bone fragments, and increase the fixation force for nonunion treatment.
微型接骨板最初是作为足部和手部骨折的固定物而开发的，但现已用于治疗小骨碎片的固定、长骨骨折的复位和难以治疗的骨不连治疗。在本研究中，作者使用微型板治疗上肢、下肢和骨盆骨折，取得了良好的效果。在此，作者报告这些良好的结果并回顾微型板的当前概念。
本回顾性研究纳入了 2012 年 3 月至 2017 年 3 月期间因随访时间>1 年而接受微型板治疗的 42 例患者。根据目的选择微型板，将其分为固定、复位和稳定性增强三类。对于固定，微型板用于固定下胫腓联合远端的腓骨远端骨折和严重粉碎的髌骨和鹰嘴骨折。对于复位，微型板用于胫骨骨干骨折髓内钉固定时复位胫骨，而在肱骨和骨盆骨折行确定性钢板固定前进行复位。为了增强稳定性，在插入髓内钉后，在肱骨干萎缩性骨不连处插入自体骨移植物后插入微型板。通过复习微型板在骨科骨折手术中应用的文献，分析微型板的有效性。
所有病例均获得骨性愈合。未观察到特定的术后并发症；然而，两名患者在植入物取出后仍存在轻度疼痛和活动范围受限。六篇关于使用微型板治疗骨折的研究报告了临床效果良好。
微型板不仅仅是小金属板。根据骨折的位置和治疗方法，微型板可以有效地固定小骨碎片，帮助主板维持大骨碎片的复位，并增加骨不连治疗的固定力。
