带关节外支架结合有限内固定治疗高能量桡骨、胫骨远端骨折

Articulated External Fixators Combined with Limited Internal Fixation to Treat High Energy Fractures of the Distal Radius and Tibia

目的:探讨应用带关节外支架结合有限内固定治疗桡骨、胫骨远端高能量损伤致粉碎性骨折的临床疗效。方法:2001年9月～2003年6月,应用单侧带关节外支架跨腕、踝关节外固定结合微创切开复位、骨片钉等有限内固定治疗桡骨、胫骨远端高能量损伤所致重度粉碎性骨折共28例31处(桡骨11例13处,胫骨17例18处)。结果:平均随访时间:桡骨6个月,胫骨10个月;骨折平均愈合时间:桡骨2.8个月、胫骨5个月,所有病例均无感染、皮肤坏死、神经血管损伤及骨折畸形愈合等并发症,根据Anderson(桡骨)、Edwards(胫骨)评分标准,腕、踝关节功能满意。结论:应用带关节外支架结合有限切开复位内固定是治疗桡骨、胫骨远端高能量损伤所致的粉碎性骨折的有效方法,具有手术创伤小、并发症少、关节功能恢复满意等优点。

Objective:To discuss the curative effect from using articulated external fixators combined with limited internal fixation to treat comminuted fractures of distal Radius and Tibia caused by high enengy injury.Methods:From September 2001 to June 2003,28 patients (31 fractures) with comminuted distal radius (11 patients) and tibial fractures(17 patients) suffered from high energy injury were treated with articulated external fixator combined with limited open reduction and internal fixation.Results:The 28 patients were followed up with an average period of 6 months (ridius:range from 3 to 10 months ) or 10 months (tibial:range from 5 to 16 months),The average time of fracture union was 2.8 months (ridius) or 5 months(tibial). No complications such as infection、skin slough、neurovascular injury or deformity of healing accurred.The function of the wrist and ankle was good.Conclusions:The clinical result of using articulated external fixators combined with limited internal fixation for comminuted fractures of distal radius and tibial caused by high energy injury was very satisfactory.