胫腓骨远端骨折的治疗

目的探讨胫腓骨远端骨折的治疗方法。方法对48例胫腓骨远端骨折患者采用管形石膏治疗5例，外固定支架治疗28例，内固定治疗15例。随访6月～2年，观察患者骨折愈合情况及愈合时间。结果管形石膏治疗5例全部骨性愈合；外固定支架治疗28例中，1例出现针道渗液，经治疗后均骨性愈合；内固定治疗15例，4例出现皮瓣坏死，经皮辩转移术后均骨性愈合。结论对腔肿骨远端骨折的治疗必须严格掌握手术指征，能手法复位成功的就不手术治疗；术中尽量保护断端周围血供，能使用外固定支架就尽量不用内固定，如有骨质缺损须行一期植骨术。

The surgical treatment of distal tibiofibula fractures

Objective To investigate the surgical treatment of distal tihiofihula fractures. Methods Among the 48 patients with distal tibiofibula fractures, 5 cases were treated with plaster cast, 28 cases with outer fixed holster and 15 cases with internal fixation. All the patients were followed up for 6 to 24 months. The periods of fracture healing were observed. Results The average period of fracture healing with plaster cast, outer fixed bolster, and internal fixation was 8.9 months, 13.1 months, and 14.7 months, respectively. 5 patients treated with plaster cast got expecting treatment effect. 27 cases of 28 patients treated with outer fixed bolster were healed, 1 patient with needle track leakage. 11 cases of 15 patients treated with internal fixation recovered, and 4 patients with necrosis of skin flap. Conclusions The present study indicates that manual reposition demonstrates preponderance compared to operation.