开放性胫腓骨骨折治疗回顾

Review of the Therapies of Open Fracture in Tibia and Fibula

目的 探讨开放性胫腓骨骨折治疗的体会。方法 回顾性分析采用钢板、交锁髓内钉、外固定架治疗78例81肢的临床资料。结果 随访时间6～33个月，按Johner-wruh标准评定疗效，钢板内固定组优12肢，良7肢，中5肢，差1肢，优良率76％；交锁钉固定组优14肢，良8肢，中2肢，优良率91．6％；外固定架组优12肢，良9肢，中8肢，差3肢，优良率65．6％。结论 早期清创，良好复位和坚强固定，Gustilo Ⅱ度以下行钢板或交锁钉内固定，Ⅲ度以应用外固定架治疗为宜。

Objective To discuss the experience of treatment of open fracture in tibia and fibula. Methods To analyze of 78 Cases（81 limbs）underwent internal fixation with steel plate or interlocking intramedullary nails,external fixture. Results After all Cases were followed up for 6～33 months, with Johner-wruh Criterion evaluation,the percertage of successful outcomes was 76% in steel plate and 91.6% interlocking intramedullary nail ,and 65.6%in external fixture. Conclusion With early debridement,satisfactory reduction,rigid fixation,Type Gustilo Ⅰ and Ⅱ fractueres may use internal fixation with steel plate or intrelocking nail,Type Gustilo Ⅲ fractures may use external fixture.