单臂多功能外固定支架治疗胫腓骨开放性粉碎性骨折

目的探讨单臂多功能外固定支架治疗胫腓骨开放性粉碎性骨折的优越性、指征、疗效及并发症的防治。方法自2005年10月至2007年8月应用单臂多功能外固定支架治疗56例胫腓骨开放性粉碎性骨折，按Gustilo分型为Ⅰ型8例，Ⅱ型28例，ⅢA型11例，ⅢB型7例，ⅢC型2例。在彻底清创的基础上直视下复位，采用单臂多功能外固定支架治疗。结果本组56例病例均获8个月到2年随访，平均13个月，均达骨性愈合，骨折愈合时间为6—12个月，平均8．2个月。3例发生浅表感染，2例发生骨折延迟愈合、12例出现针孔周围发红或少量渗出物，无一例断钉或深部感染，2例患者术后踝关节功能有不同程度的活动受限。结论单臂多功能外固定支架治疗胫腓骨开放性粉碎性骨折操作简便、手术创伤小、骨折愈合快、骨折愈合率高、感染率低，对于伴有严重软组织损伤的粉碎性骨折，尤为适用。

Treatment of open tibia-fibula shatter fracture with single lateral multifunctional external fixator

Objective To study the advantages, indications, curative effects, and prevention of complications in the treatment of open tibia - fibula shatter fracture with single lateral multifunctional external fixator. Methods 56 eases of open tibia - fibula shatter fracture from Oct. 2005 to Aug. 2007, including 8 type Ⅰ , 28 type Ⅱ ,11 type ⅢA,7 type ⅢB,and 2 type ⅢC,aecording to Gustilo classification, were reduced and fixed with single lateral multifunctional external fixator after thoroughly debfidement. Results All patients were followed up for 8 -48 months, with the average time being 13 months. All patients had bony union within 6 - 12 months, with the average time of bone union being 8.2 months. The outcome was satisfactory. 3 cases had superficial infection. 2 cases had delayed union. 12 cases had slight pin infection. All cases had no screw breakage and deep infection. 2 patients had limitation of motion of ankle joint. Conclusion The advantages of single lateral multifunctional external fixator in treatment of open tibia - fibula shatter fracture are less traumatic, easy to use, beneficial to fracture healing, having high rate of bone union and low rate of infection. It is especially useful when the soft tissue is destroyed heavily.