临床医学论文-锁定加压钢板治疗胫骨远端骨折

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1、临床医学论文•锁定加压钢板治疗胫骨远端骨折【摘要】口的探讨锁定加压钢板(lockingcompressionplate,LCP)治疗胫骨远端骨折的效果。方法对我院2001年1月至2005年2月采用LCP治疗的胫骨远端骨折，选择其中资料完整、随访有效者共42例，进行分析。年龄(45.3±7.2)岁，按A0分型A型10例，B型19例，C型13例。软组织好的病例早期切开复位LCP内固定，软组织条件不好的病例用阶段治疗，早期跟骨牵引，软组织恢复后二期切开复位，LCP固定。术后随访(13・5±2.3)个月。结果有1例切口裂开，2例切口浅表感染，换药后均很快愈合。骨浙

2、愈合时间为A型(17.5±3.5)周，B型(19.3±4.1)周，C型(21.4±4.3)周。无畸形愈合、不愈合、肢体缩短、关节面二期塌陷。根据Tornetta等临床治疗结果评价标准进行评价，术后12个月踝关节综合功能恢复情况优良率为A型100%,B型89.5%,C型76.9%。结论选择软组织损伤较轻的病例，把握正确的手术吋机，采用LCP治疗胫骨远端骨折是一种好的微创的治疗方法。【关键词】胫骨骨折；Pilon骨折；LCP；空心钉；微创Abstract：ObjectivcApproachingtheeffectoftreatmentofdisaltibiaf

3、racturewithLockingCompressionPlate(LCP)・MethodsWereviewedthedistaltibiafracturestreatedinourhospitalbetweenJan2001andFeb2005.42caseswithcompletedataandeffectivefollowupwerechosenandanalyzed.Agewas45.3+7.2years.AccordingtoAOelassification,10easesweretypeA,19easesweretypeBand13eases

4、weretypeC.Patientswithgoodsofttissueconditionweretreatedwithstagedprotocols.Afterthecalcanealtractioninthefirststage,thesofttissuerecoveredandthenthepatientsweretreatedwithopenreductionandLCPinternalfixation.Thetimeoffollowupwas13.5土2.3months.ResultsOnecasesufferedfromdisruptionof

5、wound.2casessufferedfromthesurfaceinfectionofincision.Buttheyhealedfromchangingofthedressinshortterm.Themeanhealingtimewas17.5+3.5weeksincasesoftypeA,19.3±4.1weeksincasesoftypeBand21.4±4.3weeksincasesoftypeC.Therewasnopatientwithmalunion,nonunion,shorteningof1imborsecondaryclaspof

6、articularsurface.AccordingtoTornettaclinicalstandardoftherapeuticresult.Therateofexcellentandgoodcomprehensivefunctionofanklewas100%incasesoftypeA,89%incasesoftypeBand77.4%incasesoftypeCatthepostoperative12monthes.ConclusionForthepatientswithgoodsofttissuecondition,thetreatmentwit

7、hLCPattherighttimeisagoodmanagementprotocolwithminimallyinvasive.Keywords：tibiafracture；piIonfracture；LCP；cannulatedscrew；minimallyinvasive胫骨远端骨折有很多种治疗方法，包括切开复位钢板内固定、空心钉固定、外固定支架/外固定支架结合有限内固定、两阶段方案治疗。前一种方法因很高的并发症发生率现已很少应用，口前常用的为外固定支架和两阶段方案治疗。而两阶段方案治疗又有很多种固定物选择，常用的右三叶草钢板、空心钉、解剖钢板及锁定

8、加压钢板(lockingcompressionplale,LCP)