锁定钢板外固定治疗胫骨中下段骨折

目的：探讨锁定钢板外固定治疗胫骨中下段骨折的临床疗效。方法：自2010年1月至2013年1月,采用锁定钢板外固定治疗18例胫骨中下段骨折患者,其中男11例,女7例;年龄13~80岁,平均53.5岁;病程2 h~3 d。骨折按AO分型：A型4例,B型11例,C型3例。开放骨折6例（Gustilo分型：Ⅰ型2例,Ⅱ型3例,Ⅲ型1例）,闭合骨折12例。观察患者的手术时间、术后并发症情况,并采用Johner-Wruhs评价标准对术后疗效进行评价。结果：18例患者获随访,时间6~15个月,平均11个月。2例发生局部皮肤坏死（其中1例骨外露）,2例骨折延迟愈合（均为开放性骨折）,1例钉道感染,均无螺钉松动及折断发生。按Johner-Wruhs评价标准,优10例,良6例,可2例。结论：锁定钢板外固定是治疗胫骨中下段骨折的有效方法之一,具有手术损伤小、手术时间短、术后并发症少、功能恢复好的优点。

Locking plate external fixator for the treatment of middle and distal tibial fractures

Objective：To evaluate the effectiveness of locking plate external fixator in treating middle and distal tibial fractures. Methods：From January 2010 to January 2013,18 patients suffered from middle and distal tibial fractures were treated by locking plate external fixator, including 11 males and 7 females, with an average age of 53.5 （ranged from 13 to 80） years old, the course of disease ranged from 2 h to 3 d. According to AO classification, 4 cases were type A, 11 cases were type B and 3 were type C. Among them, 6 patients were open fracture,including 2 cases with type ] , 3 cases with type 1] and 1 case with type ~ ,according to Gustilo classification）, 12 patients were close fracture.Operation time ,postoperative complications were observed, and Johner-Wrnhs scoring were used to evaluate clinical outcomes. Results： All patients were followed up from 6 to 15 （meancd 11 ） months. Two cases occurred skin necrosis （1 ease occurred bone exposure）, 2 cases occurred delayed u- nion （a11 were open fracture）, and 1 case occurred nail infection. No screw loosening or broken occurred. According to Johner- Wruhs scoring, 10 cases obtained excellent result,6 cases good, and 2 cases fine. Conclusion：Locking plate external fixator for the treatment of middle and distal tibial fractures,which has advantages of lessen damage, shorter operative time,less complications and rapid functional recovery ,is one of good choice.