开放性胫骨骨折的3种固定方法比较

目的 通过比较3种固定法治疗开放性胫骨骨折的疗效，从而寻找更有效的治疗开放性胫骨骨折的方法。方法 将收治的228例分为3组：分别用扩髓交锁髓内钉（A组）、非扩髓带锁髓内钉（B组）、分阶段多功能外固定架和石膏外固定（C组）进行治疗，比较疗效。结果 本组随访4～58个月，术后深部感染方面无明显差别；术后患肢延迟愈合及骨不连发生率A、B组较C组明显少；C组的关节活动优良率略低于A、B组。结论 两种髓内钉固定法治疗开放性胫骨骨折效果均佳，分阶段多功能外固定架和石膏外固定次之。

Comparison of three fixation devices for treatment of open fracture of tibia

Objective To seek more effective cure for the open fracture of tibia through studying the value of three fixation devices(interlocking intramedullary nail,multi-stage multifunctional extra-frame and gypsum and non-expanded intramedullary nail) for the open fracture of tibia.Methods Patients were randomly divided into three groups.The injuries were fixed and treated with interlocking intramedullary nail,multi-stage multifunctional external-frame and gypsum,and non-expanded intramedullary nail,respectively.The curative effects were compared.Results Patients were followed-up for 4-58 months after operation.There was no obvious difference in deep infection.Number of patients who suffered from postponed bone union and non-union of bone was obviously lower for the externalfixation group,compared with other two intramedullary nail fixation groups;cases with good activity of joint movement in the multi-stage multifunctional externalfixation frame and gypsum fixation group was slightly less than the other two groups.Conclusion The curative effect for the open fracture of tibia with two intramedullary nail fixation methods is better than that with multi-stage multifunctional external-frame and gypsum fixation method.