脛骨遠位部骨折に対するＭＩＰＯ法の治療成績

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We report our experiences with minimally invasive plate osteosynthesis (MIPO) for distal tibial fractures (AO types 43A-C) from January 2005. There were 9 men and 1 woman with a mean age of 52.9 years. The mean follow-up was 9.2 months. We used a Narrow LC-LCP in 2 cases and an LCP Distal Tibia Plate in 8 cases. In all cases, the fractures were united both clinically and radiologically at a mean of 4.3 months after the procedures. There was no deep infection, loss of reduction, or implant failure. According to Burwell's criteria, the radiographic results were anatomical in 8 cases and poor in 2. Objective results were good in 8 cases and poor in 2. Subjective results were good in 8 cases and poor in 2. In the MIPO technique, it may be difficult to obtain anatomical reduction because the fracture site cannot be observed directly. As we performed reduction onto the plate using a cortical screw in 4 cases of residual axial malalignment after closed reduction, anatomical reduction was obtained. For concomitant fibular fractures, we used a K-wire in 7 cases and obtained good union. The mean period of full weight-bearing was 9.2 weeks, which was shorter than in other series. We consider that earlier mobilization is allowed because of the good angular stability of LCP.
中国・四国整形外科学会の論文