胫骨下段粉碎性骨折手术治疗

Operative Treatment of Comminuted Fractures of Distal Tibia

目的探讨胫骨下段粉碎性骨折的治疗方法和临床疗效。方法对2004-01/2006-12收治的58例胫骨下段粉碎性骨折的患者的手术时机、延期切开复位、应用胫骨远端外侧解剖型钢板内固定、预防性植骨等进行回顾性分析。结果术后随访827个月,平均16.8个月,伤口均一期愈合,所有病例获得骨性愈合,平均愈合时间5.2(47)月个。按Mazur评分标准:优22例,良27例,可8例,差1例,优良率84.4%,所有患者无切口感染、皮肤坏死和骨不愈合等严重并发症。结论胫骨远端外侧解剖型钢板是治疗胫骨下段骨折的理想内固定器,选择合适的手术时机、预防性植骨是取得满意疗效的保证。

Objective To investigate the curative effect and methods of distal tibial fracture by operation.Methods From Jan. 2004 to Dec. 2006, Fifty-eight cases of distal tibial fracture were treated in the department. All cases were treated with open reduction, internal fixation with external anatomic plates, and with bone grafting prophyacticly in 37 cases. The operation would be done on 10 - 14 days after fracture. They were followed up and analyzed retrospectively. Results All cases were followed up for 8 - 27 months （average 16.8 months）. All wounds were primary healing and all fractures obtained bone-union . Twenty-two cases were the excellent, 27 cases were the good according to Mazur＇s criteria. The excellent and good rate was 84.4%. All cases had no severe complication, such as wound infection, cutaneous necrosis and bone nonunion. Conclusion Anatomic plate of distal tibia is a perfect choice for treatment of distal tibial fracture . Operative juncture and prophylactic bone grafting were very＇ important to obtain satisfactory effect.