分次手法复位加自制小夹板外固定治疗胫骨干骨折

Therapeutic effects of multi-stage manipulative reduction and splint fixation in 22 patients with tibia shaft fracture

目的:探讨分次手法复位加小夹板外固定治疗胫骨干骨折的方法及疗效。方法:回顾分析收治的22例闭合性胫骨骨折患者,男14例,女6例;年龄6～54岁,平均33岁;单纯胫骨干骨折15例,胫腓骨双骨折7例;胫骨上段骨折3例,中段骨折4例,下段骨折15例。骨折类型:斜形8例,螺旋形5例,粉碎性4例,横形5例。全部采用分次手法复位小夹板外固定治疗。结果:全部患者经3～15个月,平均6个月随访,骨折畸形愈合1例,骨延迟愈合1例,骨不连1例。依据王旭东疗效评定标准,优18例,良3例,差1例。结论:在传统手法复位小夹板外固定的基础上,给予分次手法矫正以稳定骨折端,防止骨折再移位是治疗闭合性胫骨骨折最可靠的方法之一,具有操作简单、固定可靠、对关节功能影响小、骨折愈合快、并发症发生率低的优点。

Objective ：To study the method and effects of multi-stage manipulative reduction and homemade splint fixation in the treatment of tibia shaft fractures. Methods ：Twenty-two patients （ 16 male and 6 female） were involved the retrospective study. The average age was 33 years （from 6 to 54 years）. Single tibia shaft fracture was in 15 cases and tibiofibular fracture in 7 cases. Fracture site ： 3 cases were in the upper part of the tibia, 4 in the middle part and 15 in the lower part. Fracture pattern- oblique fracture was in 8 cases, spiral fracture in 5 cases, comminuted fracture in 4 cases and transverse fracture in 5 cases. All the patients were treated with multi-stage manipulative reduction and homemade splint fixation. Results：All the patients were followed up from 3 to 15 months （mean 6 months）. There were malunion of fracture in 1 case,delayed union in 1 case and nonunion in 1 case. The results were excellent in 18 cases ,good in 3 cases and poor in 1 case according to WANG Xu-dongassessment criteria. Conehtsion： On the base of traditional manipulative reduction and splint fixation, multi-stage manual correction could stabilize the broken part and prevent displacement. It had the characteristics of easy operation ,reliable fixation, rapid union of fracture, few complications and influences on joint function. Multi-stage manipulative reduction and homemade splint fixation is one of the most reliable methods for closed tibia fracture.