前内侧钢板固定治疗胫骨骨折

目的 :探讨胫骨骨折的张力侧。方法 :对用钢板螺钉固定于胫骨内侧面的胫骨骨折 3 1例进行回顾性分析。其中男 2 2例、女 9例 ,年龄 17～ 63岁 ,左侧 2 0例、右侧 11例。车祸伤 2 4例 ,跌伤 7例。横形骨折 10例 ,粉碎性骨折 2 1例。用普通钢板固定 18例 ,加压钢板固定 13例。切除小腿前内侧被胫骨骨端顶压而缺血失活的皮肤 ,并作减张缝合。结果 :所有骨折固定术后骨折端紧密接触 ,未见骨折端张开。随访 10个月～ 2年 ,骨折全部愈合 ,平均愈合时间为 8周。膝踝关节功能完全恢复 ,小腿皮肤无坏死感染。结论 :胫骨骨折的张力侧位于胫骨的前内侧 ,钢板螺钉应安放在胫骨的内侧面 ,并不会引起皮肤坏死 ,且具有生物力学和生物学的优势。

Treatment of Tibial Fracture with Plate and Screws Placed at Anterior-medial of Tibia

Objective: To Evaluate the tension side of tibial fracture.Methods:Retrospective analysis was made for 31 cases with fracture of tibia in which plate and screws were placed anterior medial surface of tibia.Of the patients,22 cases were male and 9 female,age ranging from 17 to 63 years old.Transverse fractures were 10 cases and comminute 21. 18 cases were fixated by standard plate and 13 by dynamic compression plate.Ischemic and devitalized tissue were resected and the incisions were sutured with decompresion.Results:31 cases were followed up for an a averge 16 months.All fractures were completed healed.The time for fracture union averaged 8 weeks.The function of the knee and ankle joint was complete recovered and without necrosis and infection.Conclusion:Tension side of tibial fracture is located anterior medial of tibia,plate and screws must be placed medial surface of tibia.and do not cause skin necrosis.It has the advantages of biomechanics and biology.