Ⅱ期微创手术治疗复杂胫腓骨骨折

目的探讨严重复杂胫腓骨骨折Ⅱ期微创手术方法及疗效。方法回顾性分析2003年10月．2006年6月微创治疗胫腓骨复杂骨折病例147例。A0分型：42C1型76例、42C2型41例、42C3型30例。中上1／3段31例，中1／3段66例，中下1／3段50例。其中53例为开放性，Gustilo分类Ⅰ度17例、Ⅱ度28例、Ⅲ度8例，余为闭合性。所有病例手术均为Ⅱ期进行。早期以全身及局部情况恢复为主，骨折先予以外固定支架或跟骨结节牵引术等暂时固定。待情况稳定后，Ⅱ期采用微创技术对骨折予以内固定，内固定物选用交锁髓内钉（103例）或钢板（44例），术后不辅以其他外固定。第2天开始不负重关节功能锻炼。结果所有病例均得到随访。伤口愈合可，骨折无延迟愈合、畸形愈合。骨折临床愈合时间髓内钉组及钢板内固定组分别为14．7周及15．1周。根据Johner—Wruhs评分，优良率分别为93％及89％。结论正确应用微创技术Ⅱ期治疗严重复杂胫腓骨骨折可取得满意的疗效。

Secondary Operation for Complicated Tibia and Fibula Fractures with Minimally Invasive Surgery

Objective To investigate the appropriate methods and effect of secondary surgical operation in the treatment of severely complicated tibia and fibula fractures.Methods From 2003 October to 2006 June,147 cases of patients with tibia and fibula fractures received surgical operation.Among the cases,76 were type 42C1,41 were type 42C2 and 30 were type 42C3.Regarding to the fracture locations,the upper,middle and lower 1/3 leg were 31,66 and 50 cases respectively.There were totally 53 cases of open fracture,incl...