有限内固定加外固定架治疗胫腓骨开放性粉碎性骨折的临床评价

目的:总结使用有限内固定加单侧多功能骨科外固定支架治疗胫腓骨开放性粉碎性骨折的临床经验,提高胫腓骨开放性粉碎性骨折的治疗水平。方法:2000年1月～2005年12月使用有限内固定加单侧多功能骨科外固定支架治疗胫腓骨开放性粉碎性骨折,有完整随防记录38例。有限内固定:1枚螺丝钉固定15例,2枚螺丝钉固定13例,3枚以上螺丝钉固定10例。有限内固定中螺丝钉结合可吸收线固定11例。外固定:采用单侧多功能骨科外固定支架。伤口一期缝合34例,二期缝合4例。结果:疗效评定采用JoherWruh评分标准:优:33例,良:5例,治愈率97.4%,无骨折不愈合及畸形愈合,无术后严重感染及钢针折断弯曲。1例发现骨折成角移位。1例皮肤坏死致骨外露。结论:有限内固定加单侧多功能骨科外固定支架治疗胫腓骨开放性粉碎性骨折可有效地稳定骨折,便于临床对伤肢软组织处理,有利于患肢的早期功能恢复及骨折的愈合。

Limited internal fixation with external fixator for open comminuted fracture of tibia and fibula

Objective To sum up the clinical experiences of limited internal fixation with unilateral external fixator in open comminuted fracture of tibia and fibula,and improve the treatment of open comminuted fracture of tibia and fibula.Method The use of limited internal fixation with unilateral external fixator in open comminuted fracture of tibia and fibula,and 38 cases with complete records.Limited internal fixation：a screw fixation in 15 cases,two screws in 13 cases,three or more screws in 10 cases.Limited internal fixation with absorbable screws in the fixed lines in 11 cases.External fixation：Using unilateral multifunctional external fixator.Primary suture in 35 cases,secondary suture in 4 cases.Results Efficacy evaluation using Joher Wruh score criteria：excellent in 33 cases,good in 5 cases,and the cure rate was 97.4%,no nonunion and malunion,non-severe postoperative infection and needle bending break.One case was found broken into a corner displacement,and one case of skin necrosis caused by exposed bone.Conclusion Limited internal fixation with unilateral external fixator in orthopedics open comminuted fracture of tibia and fibula can effectively stabilize the fracture,facilitate the clinical treatment of soft tissue injury in limbs,are conducive to the early limb functional recovery and fracture healing.