交锁髓内钉结合钢板治疗胫腓骨中下1/3骨折

Intramedullary nail and plate treatment of the distal third lower tibiofibular fracture

目的探讨交锁髓内钉结合钢板治疗胫腓骨中下1/3骨折的临床疗效。方法对97例胫腓骨中下1/3骨折患者采用腓骨骨折解剖复位钢板内固定、胫骨骨折闭合复位交锁髓内钉内固定治疗。结果 97例均得到随访,时间12～25个月。患者伤口均一期愈合,无软组织及骨感染。腓骨骨折均愈合;胫骨达解剖复位66例,功能复位31例。胫骨骨折临床愈合时间:87例为14～24周,10例26～40周延迟愈合(6例经髓内钉动力化后愈合,4例取髂骨植骨后愈合)。疗效采用Johner-Wruhs评分标准评定:优81例,良11例,可5例。结论交锁髓内钉结合钢板治疗胫腓骨中下1/3骨折,创伤小,固定稳定性好,骨折愈合率高,功能恢复快,疗效满意。

Objective To study the clinical effect of intramedullary nail and plate treatment of the distal third lower tibiofibular fracture.Methods 97 cases of the distal third lower tibiofibular fractures were reduced and fixed the fibula fracture anatomically with plate,reduced the tibia fracture indirectly,fixed up the tibia fracture by using intramedullary nail.Results 97 cases were followed up for 12-25 months.The wounds were cured without parenchyma infection or bone infection.fibular fracture healed successfully in all cases.66 cases of the tibia fracture were almost anatomically reduced,and 31 cases were reduced functionally.The time of 87 cases tibia clinical healing was 14-24 weeks.10 cases got healing delay,and 6 cases healed by turn to intramedullary nail dynamiczation,4 cases healed by iliac bone grafting,the 10 cases clinical healing was 26-40 weeks.The results were evaluated according to the Johner-Wrushs grade standard,which were excellent in 81 cases,good in 11 and fair in 5.Conclusions Intramedullary nail and plate treatment of the distal third lower tibiofibular fracture requires minimal trauma,provides good stability,high rate bone healing and quick functional rehabilitation,and satisfactory clinical outcomes.