外固定支架结合腓骨移位治疗胫骨长段开放性粉碎性骨折30例

Treatment of open tibial comminuted fracture by the external fixator combined with fibular grafting

目的:探讨应用外固定支架结合腓骨移位治疗胫骨长段开放性粉碎性骨折的临床效果.方法:对30例胫骨长段开放性粉碎性骨折(Gustilo 3型)患者行带皮瓣腓骨移位或单纯带血管蒂腓骨移位结合外固定器治疗.结果:全部患者随访8～39个月,平均12个月.23例Ⅰ期愈合,7例Ⅱ期愈合.移位腓骨均在术后4～8个月与胫骨愈合,胫前软组织修复良好.所有患者膝踝关节活动正常.结论:应用外固定支架结合腓骨移位能有效修复胫骨长段开放性粉碎性骨折.

Objective： To study the effect of fibula grafting on treatment of long segment of open comminuted tibial fracture. Methods： From 1996 to 2004, 30 cases of long segment of open comminuted tibial fracture （Gustilo Ⅲ）were treated by the external fixator combined with fibular grafting with vascular pedicle skin flap. Results： After follow-up of 8 months to 39 months with an average of 12 months, fracture primary healing was found in 23 cases and delayed union in 7 cases. The fibula of grafting healed with tibia in 4 to 8 months postoperation and the anterior soft tissue of tibia repaired well. In all cases, the joint function of knee and ankle was normal. Conclusion： The external fixator combined with fibuiar grafting with vascular pedicle skin flap is suitable for treatment of long segment of open comminuted tibial fracture.