外固定器结合有限内固定治疗Ⅲ度开放性胫腓骨骨折

目的探讨外固定器结合有限内固定治疗严重胫腓骨开放性骨折的临床疗效。方法28例GustiloⅢ型胫腓骨开放性骨折,减张缝合11例,局部皮瓣转移7例,腓肠肌皮瓣6例,腓肠神经营养血管皮瓣4例。均一期闭合创面,骨折采用外固定器结合有限内固定进行固定。结果随访12～40个月。其中3例有针道感染,无骨髓炎发生,28例骨折均愈合,愈合时间6～18（9±3）个月。结论外固定器结合有限内固定治疗GustiloⅢ型骨折具有操作简单,固定可靠,微创,可同时处理骨缺损,但需防治针道感染。

External fixation combined with limited internal fixation for type Ⅲ open fracture of tibia and fibula

Objective To investigate the clinical effects of external fixation combined with limited internal fixation on serious open fracture of tibia and fibula. Methods 28 eases of Gustilo type Ill open fractures of tibia and fibula were treated. During surgery, retension suture, local skin flap, gastrocnemius muscle flap and sural neurovascular fasciocutaneous flap were carried out in 11, 7, 6, and 4 cases respectively. Primary wound closure, and external fixation combined with limited internal fixation were applied. Results Follow-up investigations were carried out for a period of 12 -40 months. 3 eases got pin tract infections, but without osteomyelitis. 28 cases of fracture healed, and the healing time were 6 - 18 months, with an average of 9 ±3 months. Conclusions External fixation combined with limited internal fixation for type Ⅲ fracture of tibia and fibula is simple, reliable, and minimal invasive. Bone defect can be treated simultaneously. However, it requires the treatment of pin site infections.