分次手法复位加自制小夹板外固定治疗胫骨干骨折

目的：探讨分次手法复位加小夹板外固定治疗胫骨干骨折的方法及疗效。方法：回顾分析收治的22例闭合性胫骨骨折患者,男14例,女6例;年龄6～54岁,平均33岁;单纯胫骨干骨折15例,胫腓骨双骨折7例;胫骨上段骨折3例,中段骨折4例,下段骨折15例。骨折类型：斜形8例,螺旋形5例,粉碎性4例,横形5例。全部采用分次手法复位小夹板外固定治疗。结果：全部患者经3～15个月,平均6个月随访,骨折畸形愈合1例,骨延迟愈合1例,骨不连1例。依据王旭东疗效评定标准,优18例,良3例,差1例。结论：在传统手法复位小夹板外固定的基础上,给予分次手法矫正以稳定骨折端,防止骨折再移位是治疗闭合性胫骨骨折最可靠的方法之一,具有操作简单、固定可靠、对关节功能影响小、骨折愈合快、并发症发生率低的优点。

Therapeutic effects of multi-stage manipulative reduction and splint fixation in 22 patients with tibia shaft fracture

Objective: To study the method and effects of multi-stage manipulative reduction and homemade splint fixation in the treatment of tibia shaft fractures. Methods: Twenty-two patients(16 male and 6 female) were involved the retrospective study. The average age was 33 years(from 6 to 54 years). Single tibia shaft fracture was in 15 cases and tibiofibular fracture in 7 cases. Fracture site:3 cases were in the upper part of the tibia,4 in the middle part and 15 in the lower part. Fracture pattern:oblique fracture was in 8 cases,spiral fracture in 5 cases,comminuted fracture in 4 cases and transverse fracture in 5 cases. All the patients were treated with multi-stage manipulative reduction and homemade splint fixation. Results: All the patients were followed up from 3 to 15 months(mean 6 months). There were malunion of fracture in 1 case,delayed union in 1 case and nonunion in 1 case. The results were excellent in 18 cases,good in 3 cases and poor in 1 case according to WANG Xu-dong assessment criteria. Conclusion: On the base of traditional manipulative reduction and splint fixation,multi-stage manual correction could stabilize the broken part and prevent displacement. It had the characteristics of easy operation,reliable fixation,rapid union of fracture,few complications and influences on joint function. Multi-stage manipulative reduction and homemade splint fixation is one of the most reliable methods for closed tibia fracture.