有限内固定结合单侧外固定支架治疗胫腓骨开放粉碎性骨折

目的 分析有限内固定结合骨外固定技术在胫腓骨开放粉碎性骨折中的应用,探计其可行性。方法 28例接受此手术。腓骨骨折先行克氏针内固定;利用有限内固定将骨折端较大碎骨块固定于胫骨干,使不稳定骨折变成稳定性骨折,然后用单侧外固定支架固定。结果 平均随访20个月。28例中疗效优良者25例,占89.3％;骨不连者1例,,占3.9％;发生浅表感染者4例,占14.3％;钉道感染者5例,占17.8％。结论 利用有限内固定结合骨外固定治疗胫腓骨开放粉碎性骨折,创伤小,并发症少,操作简单,固定可靠,便于对软组织损伤的处理,疗效满意。

Treatment of Opened and Comminuted Tibiofibular Fracture by Applying Limiting Internal Fixation Combined with Unilateral External Fixation Apparatus

Objective To analyse the application of the technique of limiting internal fixation combined with external fixation in the opened and comminuted tibiofibular fracture,and to discuss its feasibility. Methods 28 cases who accepted this operation,firstly,were treated by Kirschner wire to deal with fibula fracture,applying limiting internal fixation to fix the some larger fragments with tibia diaphysis in order to transform the unstable fracture to the stable fracture,then treated with unilateral external fixation apparatus (UEFA) to attain good immobilization. Results The average follow-up for 20 months showed that 25 cases of all patients were cured well,the ratio being 89. 3% ;and 1 case presented nonunion,the ratio being 3. 9%;and 4 cases presented the superficial infection,the ratio being 14.3%;and 5 cases presented infection in nail path,the ratio being 17.8%. Conclusion The treatment of opened and comminuted tibiofibular fracture,by applying limiting internal fixation combined with external fixation,can decrease trauma ,reduce complication,attaim safe immobilization with the simple operation,get satisfied effect,and is more convenient to treat the injury of parenchyma.