胫腓骨中下段开放性粉碎性骨折的外科治疗

The Compound Comminuted Fracture＇s Surgical therapy of Tibiofibula Middle and Inferior Segments

目的总结胫腓骨中下段开放性粉碎性骨折的外科治疗方法。方法对144例小腿中下段开放性粉碎性骨折进行临床分型，闭合开放性伤口，固定骨折，防治感染和骨筋膜室综合症，以及晚期并发症的修复。结果本组伤口甲级愈合128例，乙级愈合14例，丙级愈合2例，伤口感染2例，骨折临床愈合时间61至113天，平均83天，骨折延期愈合3例，骨和植入物裸露5例，无骨髓炎和骨不连，急诊截肢1例。结论胫腓骨中下段开放性粉碎性骨折治疗困难，须严格遵循开放性骨折的治疗原则，全面考虑伤员全身和局部，情况综合治疗。

Destination To investigate the compound comminuted fracture＇s surgical therapy of tibiofibula＇s middle and inferior segment. Method All 144 cases of compound comminuted fracture of tibiofibula middle and inferior segment were grouped, and treated with closing patent wound, fixing fracture, anti infection, cured osteofascial compartment syndrome and advanced stage＇s complication. Result The cases of the first, second and third rate＇s healing are 128, 14and 2 respectively; the healing dates of fractures are 61 to 113, average dates are 83： the cases of deferred healing and bone＇s exposure are 5 in the same manner. Conclusion It is difficult to cure the compound comminuted fracture of tibiofibula middle and inferior segments, the region and all over the body＇s conditions of patients must be considered.