【摘要】 目的 總結應用經皮微創鋼板固定（minimally invasive percutaneous plate osteosynthesis，MIPPO）技術治療2型糖尿病患者脛骨遠端骨折的臨床經驗及治療效果。 方法 2007年5月-2010年11月，采用MIPPO技術治療2型糖尿病合并脛骨遠端骨折15例。其中男9例，女6例；年齡38~70歲，平均60歲。左側脛骨遠端骨折 4例，右側 11例。單發骨折10例，多發骨折5例。根據 AO分型:A1型2例，A2型1例，A3型5例，B1型3例，B3型3例，C1型1例。傷后至手術時間為2~14 d。 結果 15例患者隨訪時間8~12個月，平均10個月。手術時間平均89 min，術中失血量平均285 mL。術后1年采用Johner-Wruhs方法評估療效:優4例，良5例，中3例，差3例；總體滿意率80%。X線片示13例患者骨折均獲骨性愈合，愈合時間4~8個月，平均6個月，無再發骨折。3例發生泌尿系統感染，1例發生呼吸系統感染，感染率26.7%。 結論 MIPPO技術治療2型糖尿病脛骨近端骨折具有對骨折周圍軟組織剝離少、符合生物學固定概念、內固定牢靠、切口較小等優點，降低了切開復位內固定術后并發癥的發生率。
【Abstract】 Objective To summarize the clinical experiences and effects of minimally invasive percutaneous plate osteosynthesis (MIPPO) technique for type 2 diabetic patients with fractures of distal tibia. Methods From May 2007 to November 2010, 15 type 2 diabetic patients with distal tibia fractures including 9 males and 6 females were treated with minimally invasive percutaneous plate osteosynthesis. Their age ranged from 38 to 70 years old averaging at 60. Left distal tibia fracture occurred to 4 cases, and right distal tibia fracture occurred to 11 cases. Ten patients had single fracture, and 5 had multiple fractures. According to AO fracture classification, there were two cases of A1, one cases of A2, five cases of A3, three cases of B1 and B3 respectively, and two cases of C1. The time from the occurrence of fracture to operation was ranged from 2 to 14 days. Results The patients were followed up for 8 to 12 months with an average period of ten months. The average operation time was 89 minutes and perioperative blood loss was (285±38) mL. Johner-Wruhs method was used to evaluate the efficacy. Four cases were excellent, 5 were good, 3 were fair, and 3 were poor, with an overall satisfaction rate of 80%. X-ray showed that 13 patients were healed. The healing time was 4 to 8 months, averaging 6 months, and no further fractures occurred. There were 3 cases of urinary tract infection and 1 case of respiratory infection with an infection rate of 26.7%. Conclusion Minimally invasive percutaneous plate osteosynthesis technique for fractures of distal tibia in diabetic patients is a safe method with better mechanical stability, less intervention of blood supply, less soft tissue complications and smaller incisions.
引用本文： 楊衡,王軍,張定偉,王陶,石波,康斌,劉都. 經皮微創鋼板固定治療2型糖尿病脛骨遠端骨折的療效觀察. 華西醫學, 2011, 26(10): 1508-1510. doi: 復制