单侧外固定架结合有限内固定治疗复杂开放性胫腓骨骨折36例

Treatment of tibiofibular fracture with limited internal fixation combined with unilateral external fixation surport:report of 36 cases

目的观察单侧外固定架结合有限内固定治疗复杂开放性胫腓骨骨折的疗效。方法回顾性分析了我院从2000年1月~2006年10月使用单侧外固定架结合螺钉、克氏针、骨片钉等有限内固定治疗的36例患者的临床资料。结果随访6~18个月,平均9.4个月,其中3例延迟愈合（8.3%）,予自体髂骨植骨更换钢板螺钉内固定获得愈合;6例伤口感染（16.7%）,2例予换药后闭合创面,4例行Ⅱ期清创局部转移皮瓣闭合创面;2例外固定针松动（5.6%）,经调整外固定架后获得稳定,无外固定针脱落及折断;6例针道感染（16.7%）,经及时切开引流,换药,局部或全身应用抗生素后感染控制。结论该手术操作简单,对骨折端干扰少,固定可靠,骨折愈合快,并发症少,是治疗复杂开放性胫腓骨骨折的有效方法。

Objective To discuss the feasibility and curative effect of limited internal fixation combined with unilateral external fixation support for treating open tibiofibular fracture. Methods To collect and analyse the information of 36 cases of tibiofibular fracture treated with limited internal fixation combined with unilateral external fixation surport in our department from January 2000 to October 2006. Results After 6-18 months follow-up, all patients＇ fracture were healed. There were 3 cases of delayed heal （8.3 % ）, 6 cases of cut infection（16.70%）, 2 cases of loose external fixation pin（5.6 %）, 6 cases of fixator hole infection（16. 7%）. Conclusion Limited internal fixation combined with unilateral external fixation support is considered an effective method with easy perform, less interference to fracture heal, firm fixation, quick heal and less complication for treating tibiofibular fracture.