CAJ | 학술논문

目的：探讨闭合手法整复经皮微创锁定钢板内固定治疗胫腓骨远端骨折的临床疗效。方法：自2009年至2011年采用闭合手法复位经皮微创锁定钢板内固定治疗60例胫腓骨远端骨折患者，其中男32例，女28例；年龄14～70岁，平均（41．22±2．06）岁。按AO骨折分型：A1型5例，A2型22例，A3型21例，C1型12例。术后观察并记录手术时间、术中出血量、骨痂出现时间、骨愈合时间，并采用Mazur踝关节评分系统对术后疗效进行评价。结果：术后Ⅰ期愈合58例，胫骨远端切口感染2例。手术时间45～90 min，平均（62．34±5．66） min；术中出血30～150 ml，平均（80．57±5．59） ml；X线片示骨痂出现时间4～12周，平均（8．24±2．06）周；骨愈合时间3～6个月，平均（4．50±1．13）个月。根据Mazur踝关节评分系统评价功能：优40例，良18例，中2例。结论：采用闭合手法整复经皮微创锁定钢板内固定治疗胫骨远端骨折，能更好地保护骨折部位的血供，同时取得更小微创切口条件下的可靠骨折固定，可获得满意的临床疗效，是治疗胫骨远端骨折的最佳选择之一。
목적：탐토폐합수법정복경피미창쇄정강판내고정치료경비골원단골절적림상료효。방법：자2009년지2011년채용폐합수법복위경피미창쇄정강판내고정치료60례경비골원단골절환자，기중남32례，녀28례；년령14～70세，평균（41．22±2．06）세。안AO골절분형：A1형5례，A2형22례，A3형21례，C1형12례。술후관찰병기록수술시간、술중출혈량、골가출현시간、골유합시간，병채용Mazur과관절평분계통대술후료효진행평개。결과：술후Ⅰ기유합58례，경골원단절구감염2례。수술시간45～90 min，평균（62．34±5．66） min；술중출혈30～150 ml，평균（80．57±5．59） ml；X선편시골가출현시간4～12주，평균（8．24±2．06）주；골유합시간3～6개월，평균（4．50±1．13）개월。근거Mazur과관절평분계통평개공능：우40례，량18례，중2례。결론：채용폐합수법정복경피미창쇄정강판내고정치료경골원단골절，능경호지보호골절부위적혈공，동시취득경소미창절구조건하적가고골절고정，가획득만의적림상료효，시치료경골원단골절적최가선택지일。
Objective:To explore clinical effects of manipulative reduction with minimally invasive percutaneous plate osteosynthesis in treating distal tibiofibular fractures. Methods:From 2009 to 2011,60 patients with distal tibiofibular frac-tures were treated by manipulative reduction with minimally invasive percutaneous plate osteosynthesis. Among them ,there were 32 males and 28 females aged from 14 to 70 years old with an average of 41.22±2.06. According to AO classification of fractures,5 cases were type A1,22 cases were type A2,21 cases were type A3 and 12 cases were type C1. Operation time, blood loss,time of callus and fracture healing were observed,Mazur scoring of ankle joint were used to evaluate therapeutic. Results:Fifty eight incisions were healed at stageⅠ,and 2 cases were infected at distal tibial. Operation time was with an av-erage of (62.34±5.66) min ranged 45 to 90 min;blood loss was 30 to 150 ml with an average of (80.57±5.59) ml;formation of callus appeared from 4 to 12 weeks,with an average of (8.24 ± 2.06) weeks,and fracture healing time was from 3 to 6 months, with an average of (4.50±1.13) months. According to Mazur scoring of ankle joint,40 cases got excellent results,18 good,and 2 fair. Conclusion:Manipulative reduction with minimally invasive percutaneous plate osteosynthesis can obtain reliable fixa-tion. It is a good choice of treating distal tibiofibular fractures by protecting blood supply of fractures.