胫腓骨骨折并发胫后血管损伤的临床诊治

目的总结中下段胫腓骨骨折合并胫后血管损伤的诊治经验。方法对58例中下段胫腓骨骨折合并胫后血管损伤患者的术前诊断、术中探查结果、治疗方法选择及治疗结果进行经验总结。结果血管损伤类型：血管卡压16例,血管挫伤7例,其中血栓形成5例,血管完全断裂35例。术后58例患肢均完全成活。随访6个月～2年,55例出现不同程度足踝及（或）足趾屈曲挛缩畸形。发生踝关节屈曲挛缩19例,行手术矫形16例;足趾屈曲畸形35例,手术矫形13例,均为小腿中段骨折病例。结论较严重的胫骨骨折常伴有不同程度的胫后血管损伤,及时手术探察修复是避免漏诊和减少术后并发症的有效手段。

Severe posterior tibial artery injury with tibial and fibular fractures

Objective To study the treatment of the severe posterior tibial artery injury with the tibial and fibular fractures. Methods 58 cases of severe posterior tibial artery injuries with the tibial and fibular fractures were analysed. Results The type of artery injury： 16 cases were found with vascular compression, 7 contusion, 5 thrombosis, and 35 vascular breakage. The legs were all survived. In the follow-up of 6 -24 months, 55 got ankle and digital contracture, and 19 got flexion contracture, of which 16 received operative correction; 35 got digital contracture, of which 13 received operative correction. All with contracture were secondary to middle tibial fractures. Conclusions Posterior tibial artery injury is common with tibial and fibular fracture, which should be treated in time.