组合式外固定架治疗胫骨开放性粉碎骨折(附118例报告)

Treatment of open complicated tibia fracture with external fixation complex

目的 评价组合式外固定架对胫骨开放性粉碎骨折的治疗效果。方法 118例患者全部为胫骨开放性粉碎骨折。按Gustilo分类 :Ⅱ型 82例 ,ⅢA2 5例 ,ⅢB11例 ,所有病例均采用组合式外固定架固定。尽量保护碎骨块血运。结果 全部病例均获得随访 ,随访时间 7～ 2 6月 ,平均 12 8月。骨折愈合时间 2 5～ 9月 ,平均 5 6月。按照Johner -wruhs评价法 :优 82例 (69 5 % ) ,良 3 1例 (2 6 3 % ) ,中 5例 (4 2 % ) ,差为 0例。优良率 95 7% ,针道感染 2 1例 ,成角畸形大于 10° 4例。结论 组合式外固定架治疗胫骨开放性骨折手术操作简单 ,创伤小 ,固定可靠 ,骨折愈合率高 ,感染率低 ,同时便于伤口的后续处理 ,是治疗胫骨开放性粉碎性骨折安全有效的方法。

Objective To evalute the value of treatment of open complicated tibia fracture with hybrid external fixation complex. Methods One hundred and eighteen patients with open complicated tibia fracture were treated with external fixation complex, and the fracture area blood circulation was tried to be protected.According to Gustilo classification:25 cases were type Ⅱ, 25 cases were type ⅢA and 11 cases were type ⅢB. Results All patients were followed. The followed-up period varied from 7 to 26 months with an average of 12.8 months. The bony union period varied from 2.5 to 9 months with an average of 5.6 months. According to Johner-wruhs criterion the result of the treatment was evaluated as excellent in 82 cases (69.5%) good in 31 cases (26.3%) fair in 5 cases (4.2%) and poor in 0 case. The total percentage of good to excellent clinical results was 95.7%. Pins passage infection were 21.Deformity healing were 4 (>10°). Conclusion The results suggest that this procedure is an easy and effective method to treat open complicated tibia fracture with the benefits of high bony union rate,low infection rate,and strong fixation.