单侧外固定支架治疗胫腓骨不同部位Ⅲ型开放性骨折的疗效比较

目的：探讨单例外固定支架治疗胫腓骨不同部位Ⅲ型开放性骨折的疗效。方法：对120例胫腓骨不同部位骨折予以单例外固定支架治疗，对其疗效进行分组研究。A组18倒，骨折部位经在胫腓骨上段近膝关节部位Ⅰ、Ⅱ区。骨折治疗需要跨膝关节固定。B组74例骨折部位往于胫腓骨中段Ⅲ、Ⅳ区，骨折治疗不需要跨关节固定。C组28倒，骨折部位位于胫腓骨远端Ⅴ、Ⅵ区，可涉及关节面，骨折治疗需要跨踝关节固定。结果：骨折愈合的非优良率A组38．9％，B组8．1％，C组28．6％。B组显著低于A、C组(P＜0．01)。B组骨折愈合后的优良率91．9％，显著高于A组(61．1％)和C组(71．4％)(P＜0．05)。结论：单侧外固定支架适应不同类型的胫腓骨不同部位的骨折的治疗，尤其对伴有软组织抉损的开放性胫腓骨骨折的治疗具有独特的优势，但对胫腓骨不同部位的骨折疗效差别较大。

A Comparison of the Treatment of GRADE Ⅲ Open Fractures in Different Zones of Tibia and Fibula With Unilateral External Fixation Apparatus

Objective To study the results of the treatment of GRADE III open fractures in different zones of tibia and fibula with unilateral external fixation apparatus. Methods 120 cases with fractures in different zones of tibia and fibula were treated with unilateral external fixation apparatus and then divided into 3 groups. Group A including 18 cases fractured in I,II zone, near the knee joint. Unilateral external fixation fixed across the knee joint. Group B including 74 cases fractured in III,IV zone. Pins were placed into the tibia without across either the knee joint or the ankle joint. Group C including 28 cases fractured in V,VI zone. The fractures might involve the articular surface of the ankle joint. Unilateral external fixation apparatus fixed across the ankle joint. Results After the stroration of these fractures the rate of both fair and poor, group A was 38.4%, group B was 8.1% , group C was 28.6% . Among these three groups the rate of group B was least (P < 0.01). The rate of both execellent and good. Group B was 91.9% . Group A was 61.1 % . Group C was 71.4% . Among these three groups the quality of group B was best ( P < 0.05). Conclusion Unilateral external fixation apparatus can be applied effectively in treatment of different types GRADE III open fracture in different zones of tibia and fibula, but the outcome can vary very much.