Ⅲ度开放性胫腓骨骨折外固定治疗策略

目的：探讨Ⅲ度胫腓骨开放性骨折早期的处理方法与技巧,总结外固定支架治疗、稳定骨折端的临床效果。方法：早期采用外固定支架治疗Ⅲ度胫腓骨开放性骨折120例,男86例,女34例;年龄18～67岁,平均36.8岁。结果：120例中111例优良,或通过Ⅱ、Ⅲ期手术,软组织修复及骨折愈合良好;1例患者因感染、骨折复位不良,骨折不愈合;8例Ⅱ期截肢。结论：对于Ⅲ度胫腓骨开放性骨折早期以外固定支架为主的治疗是一种理想的方法,术中良好的骨折复位、简单的内固定合并外固定支架为主的治疗,有利于日后软组织的修复及骨折愈合。

Therapeutic strategies of grade-Ⅲ open fractures of tibia and fibula

Objective：To explore early treatment and technique of grade-Ⅲ open fracture of tibia and fibula and to summarize the experience of the treatment with external fixation. Methods：The retrospective analysis were carried out in 168 cases of grade-Ⅲ open tibial and fibular fractures. One hundred and twenty cases were treated with external fixation,and others were treated with intramedullary nail or amputated. Among 120 patients treated with external fixation in early stage,86 were male and 34 were female. The age ranged from 18 to 67 years with an average of 36.8 years. Results：One hundred and eleven patients achieved the excellent or good results,some of them underwent later repair of soft tissues. One case was nonunion because of infection and malreduction,and amputation in later stage in 8 cases. Conclusion：Treatment with external fixation in early stage is an ideal method for grade-Ⅲ open fractures of tibia and fibula. Good reduction integrated with simple internal and external fixation is favorable for the repair of soft tissue and union of fracture.